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Full text of "Cholera and its cures : an historical sketch"

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CHOLERA AND ITS CURES 



AN 



HISTORICAL SKETCH, 



BY 

J. STEVENSON BUSHNAN, M.D. 

MEMBER OF THE ROYAL COLLEGE OF SURGEONS, 
AND FELLOW OF THE ROVAL COLLEGE OF PHYSICIANS OF EDINBURGH. 



LONDON: 
Wm. S. ORR and CO., AMEN-CORNER. 

1850. 






LONDON : 
PRINTED BY WILLIAM TYLER, 

BOLT-COURT. 



THESE PAGES 

ARE MOST RESPECTFULLY INSCRIBED 
TO THE 

CHAIRMAN AND MAGISTRATES 

OF THE 

Cnunttf nf jSiiiMmX; 

IN TESTIMONY OF 
THEIR EARNEST AND DISINTERESTED ZEAL IN THE 

CAUSE OF TRUTH, 

WHEN, IN 1832, 

THE SALINE TREATMENT OF CHOLERA 

WAS FIRST PRACTISED, AND ITS VALUE ESTABLISHED, IN THE 
PRISON OF COLDBATH-FIELDS. 



\ 



PREFACE. 



The author of a medical work is expected to explain 
the motives which have induced him to appear before 
the pubhc. I therefore at once declare, that my sole 
motive for the publication of the following pages ■ has 
been a sense of public duty. 

Circumstances have brought before my view an im- 
mense mass of documents connected with the progress 
and treatment of Epidemic Cholera. I have closely 
observed the disease during two outbreaks in tliis 
coimtry; and reviewing the results of the treatment 
employed by a vast majority of practitioners, I have 
been forced to draw the pamful conclusion, that the 
mortality of Cholera has not been diminished a single 
iota by the means generally employed. Nay more ; I 
fear experience in hundreds of thousands of cases, 
has not advanced us one step beyond the ignorance 
of uncivilized nations. The mortality in every part of 
Europe, and under every variety of medical treatment 



VI PKEFACE. 

commonly employed, has been the same. The inevitable 
deduction from this simple fact is, that medical science, 
under its present direction, has exercised no beneficial 
influence whatever upon the termination of the disease. 
Nearly the half of those attacked have been cut off 
in every part of the world. This is a sad conclusion, 
and holds forth a fearful prospect to the mind. 

It is impossible to say what may be the date of 
another outbreak ; or whether its next attack may not 
be attended with tenfold violence ; but an intimate ac- 
quaintance with the history of Epidemic Cholera in the 
United Kingxlom enables me to mitigate much of the 
alarm which would otherAvise attend such a statement, 
and to relieve medical science from the imputation of 
insufficiency cast on our Profession through want of 
general success. 

To Dr. Stevens we are indebted for a method of 
treatment by which the mortality from Cholera was 
reduced to about five per cent, of the cases in which 
that method was employed, — a mortality, be it ob- 
served, less than that of typhus fever. Cholera may 
thus be shorn of its terrors, and subdued within the 
gi-asp of science. If the ignorant will submit to be 
enlightened, and the prejudiced will listen to reason, 
we may, I trust, look forward to any such visitation 
without apprehension or dismay. But such is the 
force of prejudice — so strongly does man's mind cling 
to preconceived opinions — so difficult is it to see truth 
through the clouds which misrepresentation or false- 
hood may liave cast o round it — that not only the doc- 



PREFACE. Vli 

trines, but tlie practice of Dr. Stevens, have met with 
the most determined opposition, and facts, supported by 
incontrovertible evidence, have been pertinaciously de- 
nied, until the public, tossed about in a flood of 
contradictory opinions, have at last taken refuge in the 
harbour of incredulity. 

The modest and retiring character of Dr. Stevens has, 
hitherto, induced him to preserve silence under a load of 
calumny \Yhich might well liave excited the indigna- 
tion of any other man. 

But the interests of humanity should prevail over all 
other considerations : and firmly convinced as I am that 
the saline treatment of Cholera is the only one which 
experience has proved to be of any avail, — nay, more, 
that it brings that dreadhil disease completely under 
medical control — I feel it my duty to lay an outline 
of the case before the Profession, without exaggeration, 
and as I firmly believe, " without setting aught down in 
malice." 

In the chapter devoted to the " Saline Treatment " a 
rapid sketch only of the circumstances connected with 
Coldbath-fields Prison, and the accusations made against 
Dr. Stevens, has been given. This part of the subject, 
with which the character of an upright and honourable 
man is so intimately connected, would have been fol- 
lowed out more completely, had I not been aware that 
another person had undertaken the task ; and thus I 
have but touched lightly on matters which will soon 
be revealed in the clearest manner. I have withdrawn 
but a portion of the curtain, yet I trust that wliat has 



Vlll PREFACE. 

been shewn will be sufficient to induce the Profession 
to suspend their judgment, should it fail to prove on 
which side lies the truth. For myself, feeling no doubt, 
I have no hesitation to declare what I know to be an 
honest opinion. 

The Tables, illustrating many important points in the 
history of the Epidemic Cholera, contain, I believe, some 
new subjects for thought, and may prove useful. 

J. S. B. 



7, Nottingham-place, Regrnt's-park, 
July, 1850. 



CONTENTS. 



PAGE 

Dedication . . iii 

Preface v 



CHAPTER I. 

Modern History of the Disease — Its Developi.ient and Progress 

IN Foreign Countries .1 



CHAPTER II. 

The Origin, Nature, and Causes of Cholera ..... 16 

CHAPTER III. 

Novel Speculations on the Cause of Cholera, promulgated in 

the last Epidemic 30 

CHAPTER IV. 

The Dwellings of the Poor a Source of Cholera , ... 37 

CHAPTER V. 

Appearance of the Cholera in England — State of the Metropolis 

and other Cities — Sanitary Measures ..... 52 



CONTENTS. 



CHAPTER VI. 

PAGE 

The Second Outbreak — 1849 85 



CHAPTER VII. 

Proposed Cures for Cholera 130 

CHAPTER VIII. 

Thf Sai.i\e Treatment 150 



Table of the Meteorological Phenomena, during the Second Out- 
break, FROM May 20th to November 10th, 1849 ; with the Deaths 
from Cholera in each week, and those (Male and Female) from 
all Causes. — (Daily.) 



CHAPTER I. L 



Modern history of the disease — Its development and progress in foreign countries. 

The naturalist, while pursuing his studies with toil and patience, 
is often embarrassed by the disappearance of the phenomenon 
which engaged his attention; it escapes his further observation, 
and he finds too certainly that the summer is ended, and his 
object unattained. Circumstances somewhat similar apply with 
peculiar force to our investigations into the causes of newly-deve- 
loped epidemics, or pestilences. They too have their seasons, and 
these generally are of short duration. Atmospheric influences 
soon dissipate the terrors of " the pestilence that walketh in dark- 
ness;" and the physician must wait for its reappearance, to study 
the pathology of the disease, and the most effective mode of treat- 
ment. But during the interval of the storm — so to speak — 
during the lull and calm that hush the atmosphere and still the 
waters, shall we remain inactive and inapprehensive of the re- 
currence of the same dread visitant ? Does the churchyard 
turf, piled over silent victims, speak no warning voice ? Do 
the ties that have been sundered, and the chasms which have 
been rent in the bosom of so many private families, teach no 
lesson ? Shall the widow^s wail and the orphan^s cry be un- 
heeded, while greedy avarice runs her race with wanton com- 
petition, expressing no sympathy for the sufferings of humanity ? 
Shall the all-wise Disposer of events send forth a warning to man 



2 INTRODUCTORY. 

in vain, and shall we, amid the triumph of our idle pleasures, 
disregard the mysterious writing upon the wall ? To these, and 
other such solemn questions, we would fain answer in the nega- 
tive ; for, amidst the gloom which yet, like a pall, overhangs the 
face of society, there are cheering indications that a more healthful 
spirit is abroad — a moral and intellectual energy, stimulating 
inquiring minds to make researches and collect facts, from which 
the most important inferences may be deduced. But the elements 
of all such inductions must be comprehensive, — that is to say, 
not composed of isolated observations, giving one set of facts 
an undue preponderance over another, and thereby leading us 
astray. The evidence should be on a suinciently broad founda- 
tion to carry with it conviction, and extinguish false lights. To 
arrive at such a result, one of the most obvious pre -requisites 
would appear to be, a faithful historical narrative of facts con- 
nected with the late epidemic ; not for the purpose of upholding 
any peculiar or favourite theory of the author, but for supplying 
data which may guide his contemporaries in threading the same 
path. Truth is universal, and many collahorateurs must conjoin 
their labours before any great discovery in science can be success- 
fully achieved. To dwell at any length on the interest of such 
a record, would surely be a work of supererogation ; for, without 
considering a host of secondary causes, which notoriously pre- 
dispose to, and aggravate the malady, and which affect our social 
well-being, who among savans would allow his scientific know- 
ledge to be cast down, and his efforts in behalf of humanity 
to be rudely foiled ? " Thus far shalt thou go, and no fai-ther ! " 
Canute is reported to have said, addressing the sea-waves, which 
advanced around him ; thereby teaching his courtiers a lesson not 
less profound in a moral than a philosophical sense. And 
although it may be, and doubtless is true, that there are heights 
in the great mystery of creation which finite beings cannot reach, 
and depths which they cannot explore, still science is progressive ; 
and the human mind is impelled onwards in search of knowledge, 
as it were, by a divine instinct, which prompts the philosopher 
to take up his torch, and make his way through the gloom of 
ignorance, until he reaches the temple of science, in the midst 
of which he stands unassailable, surrounded by the universally 
diffused and protecting light of truth. 



INTRODUCTORY. 3 

The inquiry upon which we are now about to enter may be 
difficult; for although it is certain that the laws of epidemics 
are as constant and as uniform as any of the other fixed laws 
of nature^ they are, nevertheless, extremely obscure. The subject, 
however, is one which may well interest the student, who must 
not limit his views to any one particular town, district, or country; 
but extend his observations through every latitude of the globe, — 

" From Greenland's icy mountain 
To India's coral strand." 

He must track the footsteps of the invisible enemy from town 
to town — village to village; along the banks of streams, and 
across the currents of the wide ocean ; he must halt at the mouths 
of estuaries, and penetrate into the depths of jungles; but let 
him bev/are lest, ever and anon, some tempting and fascinating 
hypothesis rise up, like the ignis fatuus in the Walpurgen of 
Faust, to lead his steps astray. It has been said, that there are 
more ^^ false facts ^^ than "false theories" in the science of medi- 
cine; and certainly, the errors of our predecessors ought to be 
regarded as beacon-lights for the guidance of their successors. 
^'^Tio can listen mthout a smile to the causes to which epidemics 
were anciently ascribed ? — the wrath of the gods — the influence 
of Satanic agency — the appearance of large stars, comets, and the 
occurrence of earthquakes. We are not disposed to deal con- 
tumaciously with the authority of our forefathers. They were 
observers, and keen observers, of facts ; nor has any modern phy- 
sician recorded his observations with more truthful accuracy than 
Hippocrates himself. 

We shall, however, for our present purpose, confine our atten- 
tion to the modern history of Cholera, without attempting to trace 
back its origin into those remote ages in which the identity of its 
character might be disputed ; in attempting which we might dis- 
tui'b from their slumbers Brahminical records, and revel among 
the legends of Hindooism, in which a somewhat similar malady is 
said to be described. We might, furthermore, be tempted to dis- 
cuss mth antiquarian zeal whether or not it were this disease 
which, in the time of Hezekiah, attacked the Assyrian army, and 
carried off in one night a hundred and fourscore thousand men. 
But these, albeit curious, are unprofitable matters of speculation, 
and we therefore content ourselves with describing the history 

B 2 



4 FOREIGN HISTORY 

of this disease during a period which will admit of living evidence 
being appealed to^ in order to establish its identity. 

In 1817, the mort de chien (or, more properly, according to the 
Persian, "mardechim"), which had never before spread beyond the 
confines of India, burst out with extreme violence in Bengal, and, 
after this period, assumed a new character, extending vfestward 
beyond the tropics, within which, if pre-existent, its ravages had 
previously been confined. Here we may remark, that it has been 
observed, not only in respect to the course of the Cholera, but of 
other pestilences, that their progress appears to be, upon the whole, 
from east to west, or in the reverse direction of the earth^s rotation. 
Thus it was with the Black Death, in the fourteenth century, 
which, originating in China, passed westward through Asia, and 
reaching the coasts of the Levant and Asia Minor, swept over 
Em-ope and Northern Africa, having the direction of its course 
somewhat modified by the physical irregularities of the earth ; 
sometimes turning off" from mountain ranges, and lurking along 
their sides until it found a pass, along which it seemingly pur- 
sued its natural way; at other times evincing a predisposition 
to travel along the course of rivers, or to pursue the tracks 
of human migration. From the mouths of the Ganges [78° 4'], 
and as far as the Jumna [70°], the epidemic Cholera took three 
different routes; south-west, south-east, and westward. By the 
first, it reached Madras [82° 2'] ; then Ceylon, and thence perhaps 
by ship to the Mauritius; by the second, it visited successively 
Arracan, the Malay Peninsula, Penang, through Sumatra, Java, 
and the Spice Islands, to Timor : thence spreading northward by 
the Phillipine Islands ; and, lastly, still taking a northerly direc- 
tion, in 1820 it reached Canton [70° 9'], Pekin [52° 8'] in 1821, 
and spread through Mongolia. 

With more rapidity than either of the foregoing courses, the 
westerly stream of pestilence reached the British army on the 
banks of the Scinde ; and in 1818 arrived at Delphi, giving off 
tributaries to Serhampore and Kotah, and proceeding northward 
until it received a check at the Himalaya [70°], and thence 
driving southward to Bombay, having its southern limit at Cape 
Comorin. In the summer of 1821 it broke out with deadly 
violence at Muscat, Bashehr [77°], and Bassorah; and from 
thence took its course to Bagdad. Here it subsided ; but as the 



OF THE DISEASE. 



next summer advanced, it made its way gradually towards Europe ; 
and in 18,23, although with much less violence, it spread west- 
ward to Antioch and other ports of the Mediterranean, and 
extended northward to Astrachan. The pestilence then paused on 
the western extremities of Europe during six years. An intelli- 
gent correspondent in the Times here remarks that, " No quaran- 
tine was enforced, no obstacle was opposed to the streams of 
human intercourse flowing westward from the infected places. 
The plague seemed to be exhausted, and the alarm which its 
proximity had excited soon ceased and was forgotten. In the 
summer of 1839 it broke out at Orenberg [35° 2'], on the 
Tartar frontier. In Orenberg and the surrounding provinces a 
tenth of the population was seized, and about a fourth of those 
attacked died." This second warning renewed for a moment the 
forgotten fears of Europeans ; but no measures were taken to resist 
the impending pestilence. With the subsidence of the disease 
during the winter, the apathy of Europe returned. No steps were 
taken to abate the filth and misery of over-crowded towns. The 
authorities permitted the grave-yards — the slaughter-houses — the 
reeking cess-pools, emitting putrid steam and mephitic air, still to 
poison the atmosphere ; while the squalid population — predisposed 
by their blood being impoverished and fevered to be attacked — 
were suffered to expose themselves during their daily labours to 
the epidemic like victims condemned to perish in the lion's path. 

In the summer of 1830 the disease again broke out in Persia. 
Still true to the usual course which it observes, it spread westward 
along the Valley of the Kur to Tiflis, and thence into Caucasia. 
From Asachan it ascended the Volga to Saratoff, and from the 
latter to Moscow. A cordon sanitaire was now thrown round that 
city, and a strict quarantine observed. Still the disease spread, 
untn in six weeks as many as 3000 persons perished. It continued 
to ascend towards the north-west, spreading from the Caspian to 
the Baltic, and also down the river Don to the borders of the Black 
Sea, reaching Odessa and the mouth of the Danube almost 
contemporaneously with its outbreak in Moscow. It next spread 
along the Valley of the Danube to Vienna ; by the Baltic it made 
its way from Petersburg to Berlin, while another stream reached 
Warsaw and Cracovv^. By these several routes it traversed moun- 
tains and plains, roads and rivers, throughout Austria, Hungary, 



6 FOREIGN HISTORY 

and Germany, and eventually reached Hamburg in the autumn 
of 1831. From the latter it was conveyed, as some believe, 
by an infected vessel to Sunderland, where it broke out on the 
26th of October, the same year. France, together with the 
Spanish and Italian peninsulas, had as yet escaped untouched. 
From Sunderland its transit was easy to the shipping in the 
Thames, and London had now fully imbibed the infection. In 
February, 1833, Edinburgh was visited, and Dublin shortly after- 
wards. Calais and Paris were affected at the same time in March. 
From these places it spread throughout France ; where the pesti- 
lence was more virulent than in England ; Paris alone numbering 
18,000 victims. In June it reached Quebec and New York, 
whence it visited the entire American continent. 

Another current now took a north-easterly direction from 
England, and attacked Lisbon and Madrid in 1833 ; from whence 
it spread, in 1834, throughout the peninsula, and, defying Alpine 
ranges, penetrated to Piedmont, Genoa, and Florence in 1835. 
From Marseilles and Toulon, which had not been visited until 
1835, the disease was carried to Algiers in 1837, and then took 
its course along the northern coast of Africa. In the same year, 
out of a population of 103,000, Malta in twelve weeks lost nearly 
4000 souls. 

After lingering for two or three years in each country after the 
date of its arrival, the Cholera subsided in Europe. In India, 
however, it again became endemic, raging yearly for a period of 
several months, and exciting the greatest alarm lest it should 
burst its bounds, and again overshadov/ the whole earth. Never- 
theless, nothing was done to provide against a second invasion, or 
to meet it upon its recurrence. It was abundantly proved that the 
Cholera, like Typhus, was prone to attack persons debilitated by 
over-work, insufficient diet, damp, crowded, ill-ventilated apart- 
ments. Everywhere the squalid abodes of the poor had been the 
chief seat of the disease, and their miserable inmates its most 
certain victims. Notwithstanding which, the filth of London was 
permitted to accumulate and ferment in its 300,000 cesspools ; the 
foul tidal ditches of Bermondsey, Shoreditch, and Lambeth still con- 
tinued polluting the surrounding atmosphere. Nor is this all ; for 
evei-y year some 40,000 more corpses had already been added to 
the soddened mass of putrescence upon which the metropolis stands. 



OF THE DISEASE. 7 

Much that is true of London is also true of Moscow, Petersburg, 
Berlin, Vienna, and Paris; as well as of Lisbon, Madrid, and 
Rome. Everywhere apathy and indifference have followed the 
subsidence of the panic. Of this apathy and indolence Europe 
is at present suffering the consequences. The pestilence now 
raging has pursued with little deviation the track of its prede- 
cessors, — travelling, however, more rapidly, and committing more 
fearful ravages than before. Many cities — e. g., Petersburg and 
Berlin — were in 1847 attacked not only in the same season, but in 
the same month, as in 1830. The same streets — nay, the very 
same houses that suffered most severely before, are suffering the 
most severely now ; and towns which, like Birmingham, escaped in 
1830, are enjoying a snnilar immunity. 

To pursue, however, the course which it observed abroad. It 
was obviously consistent with the previous history of Cholera, 
that as soon as it disappeared in one country it should be expected 
to break out, perhaps with increased severity, in another. For 
some time it had been desolating the Russian territories, when, 
by a steamer which left Cronstadt on the 17th of July, the 
gratifying intelligence was announced that the disease had sub- 
sided and was apparently over in St. Petersburg. In that city its 
ravages had been extremely disastrous — in seventeen days the 
number of deaths amounted to 7452. While the inhabitants of 
St. Petersburg congratulated themselves upon the disappearance of 
so calamitous a visitation, intelligence was brought that the 
disease had suddenly appeared, on the 32nd of July, with in- 
creased intensity at Cairo, and also at Tantat, a town on the Dami- 
etta branch of the Nile. Another letter from Tarnapolis announced 
that the Cholera had broken out fiercely at Okassa, a Russian 
tow^n, thirty leagues distant from Tarnapolis, whence it spread 
with inconceivable rapidity over the entire western frontier of 
Gallicia. At the same time the plague was not only reported to 
be raging malignantly at Stockholm, but to have penetrated into 
the interior of the country ! — into Pinland and Lapland. Letters 
from Chesme were the same month received, stating that the 
disease had there disappeared. At Bucharest it was also on the 
decline, but throughout the surromiding country its ravages con- 
tinued. 

At Jassy it was still making great havoc, from fifteen to two 



8 PROGRESS OF THE DISEASE 

hundred falling victims daily, although two-thirds of the popula- 
tion had, in their alarm, quitted the city. From the Gazette 
cVAur/sburg we learn that at this period several cases had been 
observed at Vienna, although only in a sporadic form. From Abo, 
in the grand duchy of Finland, reports were received, stating that 
the disease had there re-appeared (August, 1848), with increased 
severity. But the calamity now appeared to be spreading in every 
direction ; forty governments of Russia were visited by it ; and 
between the 26th of July and the 2nd of August, the deaths 
amounted to 546 ; while in Moscow, on the 26th of July, there 
were 1906 cases of Cholera under treatment. 

The progress of this fatal malady, as it devastated foreign coun- 
tries before its approach to our shores, was duly notified to our 
Government by official letters and despatches, from which we 
may make the following extracts : — 

D. P. Leonardi, of the Quarantine of Ancona, in a letter dated 
June 26, 1848, observes : " During the last week the Cholera has 
manifested itself in this city. The cases have averaged from four 
to five daily. The mortality here has not been great, but I regret 
to say that at Balgat, a village distant one hour to the west, 
nearly the whole population has perished." 

Another despatch from the same gentleman, dated Jassy, June 
26th, states as follows : " Since my preceding despatch of the 
19th instant, consular No. 11, I have the honour to report that 
the prevailing epidemic, the Cholera, has assumed a very violent 
character in Jassy, and that the number of casualties has varied 
from thirty to one hundred deaths per diem. The Government 
has not judged it advisable to issue any bulletins on the occasion. 
The malady offers quite a novel character. It has been so rapidly 
destructive, that persons in ^lerfect health have fallen victims to it 
in the short space of two or three hours, and the instances are 
numerous. It may be attributed, undoubtedly, to the excessive 
heat of the season. The thermometer for successive weeks has 
seldom marked less than 29° to 30° by Reaumur, or 100° by 
Fahrenheit, in the shade. At Galatz the malady has almost 
ceased ; at Ibraila and Bucharest it has diminished ; and the 
abundant rain now falling will refreshen the atmosphere, and 
relieve us from one of the chief causes of disease. In the mean- 
time the city has been abandoned by all the families who have the 



TO ENGLAND. 9 

means of quitting it, and my own chancery is deserted. All the 
tribunals are closed, as well as the schools, and vigorous measures 
are employed at the barriers, or tolls, of the city, to prevent the 
egress of whatever may propagate the malady, and regulations, 
prohibiting the introduction of various supplies, are also enforced. 
Provisions are becoming scarce and dear. 

" To add to this gloomy pictui'c, immense swarms of locusts 
have appeared in every direction, and in a tenfold amount to 
those of last year." 

Erom Odessa, June 28, 1847, Mr. Yeames addressed a letter to 
Lord Palmerston, in which he informs the Government that the 
"presence of the Cholera in this town was for the first time 
acknowledged by public authority yesterday. According to offi- 
cial report there were on that day — new cases, 133 ; deaths, 44 ; 
recoveries, 23. And from the 19th of May to the present day, 
in town and in the port — total number of cases, 824 ; of deaths, 
332; of recoveries, 235; remaining sick, 257. The present 
population of Odessa is stated to exceed 90,000 inhabitants. I 
am not yet prepared to speak on the modes of treatment adopted 
here, which, in the hands of professional men, varies very materi- 
ally under different circumstances. All condemn neglect of first 
symptoms, however trifling, recommending instant and energetic 
remedies ; and the simplest means thus applied, in numerous 
cases, have proved successful : such as large doses of the essence 
of peppermint, even brandy with pepper or ginger, and, in par- 
ticular, violent friction. The Cholera is reported to be very severe 
in Nicolayeff and Cherson, and in parts of Bessarabia. It is 
spreading throughout the country, and is advancing rapidly west- 
ward. It has likewise re-appeared in the towns on the Azoff, 
though in a very slight degree.''^ 

The next document to which we request attention is a letter 
from Mr. Sandison, our Consul at Tchekerghi, near Broussa, 
addi-essed also to Lord Palmerston : — " I lament to have to per- 
form the duty of announcing to your lordship a fearful visitation 
of the Cholera in this district. It manifested itself in the town 
about eight days ago, and the number of attacks has increased 
to sixty or seventy a day. In most cases they have not been 
fatal where prompt medical assistance was obtained. In the 
immediate vicinity of the Consulate the malady broke out, and 



10 PROGRESS OF THE DISEASE 

continues to rage with intense violence — not a house has escaped. 
It has swept off two of my domestics^ a third recovered from an 
attack_, and one of my daughters fell a victim to the scourge a 
few hours after our arrival at this village^ where the hot mineral 
springs are situated^ which escaped the former visitation in 1831^ 
and hitherto is exempt for the present. It is spread over many of 
the villages near^ and a great part of the district, extending also 
to Balahissar, and the valley of the Sangarius, from such imper- 
fect information as I can yet obtain.'^ 

From Belgrade, Mr. Fonblanque wrote word, June 30, — " In 
a letter from Alexinai, Captain Cecil Johnson says : ' There is 
nothing new here, except that on the 18th, a swarm of caterpillars, 
such as no man ever saw before, took possession of this valley, 
and by sunset had destroyed every plant. Such was the number 
of these insects that the people were turned out at four o^clock in 
the morning to destroy them with besoms, branches of trees, &c. 
The roads were literally black with them, and the house in which 
I live was covered to the first floor. The heat is overpowering, a 
breeze blowing like the hot winds of India. A Tatur from Stam- 
boul reports that the Cholera was raging in that city ! Nearly 
similar phenomena to these mentioned were observed at different 
places in 1831 and 1835, and are assumed to have some occult 
connection with Cholera. It is certainly a singular coincidence 
that (besides Alexinai) most of the valleys on the south-eastern 
frontier of Servia, and the west of Bulgaria, should have been 
covered with caterpillars (of a peculiar kind, as the peasants allege) 
just as the Cholera was advancing to within a few leagues of those 
districts; but then it should also be considered that the same 
unusual heat, which adds intensity and impulse to the disease, 
may also account for the extraordinary development of insect 
life.^ '' 

Sir Stratford Canning wrote from Therapia, July 1st, to Lord 
Palmerston, on the same subject, as follows : — " The strength of 
the disease appears to fluctuate in some degree Avith the wind, 
being on the increase whenever a south or south-east wind prevails. 

" The accounts from Broussa, Odessa, and Bucharest, not to 
mention other places of less note, are very alarming.^^ 

A despatch from Mr. Consul Gardner, dated Jassy, July 16, 
1848, stated : — " The Cholera is diminishing at Jassy, but raging 



TO ENGLAND. 11 

with violence in the country. My letters from the district repre- 
sent its effects as most destructive." 

From Cairo, Mr. Murray, July 18th, wrote : — " I regret ex- 
tremely to inform your Lordship that the Asiatic Cholera has sud- 
denly appeared here in a form of unusual malignity. ^'\^cnce or 
how it came I am at present unable to state, as no case has been 
reported from any of the ports or frontiers of Egypt. Hitherto its 
ravages have been chiefly confined to Boulak, the port of this city, 
on the Nile. On the night of the 15th instant, five cases occurred 
in that suburb ; on the 16th, eighteen ; yesterday and last night, 
forty-nine cases. What is most melancholy, and also most extraor- 
dinary, is, that although the sufferers have had all possible medical 
aid from practitioners who have had great experience in the treat- 
ment of Cholera, not one case has hitherto been saved; every single 
patient has died in the course of a few hours. The Board of 
Health have assembled, and have issued a series of precautionary 
regulations, with a view to limit the ravages of this fearful scourge ; 
but it is vain to hope that, ha\dng begun with such force and 
intensity, its progress can now be arrested by any human effort. 
The will of Providence may, indeed, cause it to disappear as sud- 
denly as it appeared ; but until some cases of successful treatment 
shall have been reported, it will be difficult for the public mind to 
be much tranquillized by the suggestions of the faculty." 

In the House of Commons, on Monday, Aug. 7th, Lord ]\Ior- 
peth read from a return the casualties from Cholera at St. Peters- 
burg, to July 24th, giving the following results : Cases, 17,742 ; 
deaths, 10,138 ; cures, 4,618 ; under treatment, 1,986. — Propor- 
tions per 100: deaths, 57; cures, 26; under treatment, 17. At 
MoscoAV the cases were, 9,754; deaths, 4,309. The accounts from 
Odessa (he said) were almost as afflicting. 

In Russia very full and judicious instructions were addressed to 
the public, with the view of suggesting means for counteracting 
the extension and fatality of the disease : 

" It has been remarked, that just before the appearance of the 
Cholera in a district, the inhabitants are troubled more than usually 
by diarrhcEa and other complaints, trifling under ordinary circum- 
stances, but which, in the presence of the epidemic, are apt, if 
neglected, to degenerate into real Cholera cases. 

" It is well known from the experience obtained in 1830 and 



12 PKOPHYLACTIC MEANS 

1831^ that the Cholera is in itself generally not contagious^ but 
that it may become so^ like some other diseases, if many sick are 
kept crowded together. 

" The Cholera has been found to be most destructive in villages 
situated on low and marshy grounds, or near bogs and stagnant 
pools, and particularly where the inhabitants are confined within 
narrow space, and live unmindful of cleanliness. 

" It has been further observed that those dejected in spirits, and 
easily alarmed, are more subject to Cholera than those who live in 
confidence, and are of good courage. 

" The preceding remarks having been made, the following are 
the precautions recommended for observance against Cholera : — 
To beware of catching cold, and particularly to protect the stomach 
from cold, for which purpose to wear a broad belt of cloth, or stout 
flannel, upon the skin around the Avaist ; not to lie upon the bare 
ground, nor to sleep at night in the open air. After sleep or hard 
labour, when in perspiration, to drink no water or other beverage 
cold ; to drink no acid beverage, and never much at a draught ; to 
beware of all things of intoxication j to use light food and mode- 
rately ; to eat no bread insufficiently baked, no crude vegetables, 
no unripe fruits, nor meat or fish not perfectly fresh, and to abstain 
from salted meats and pickled fish that provoke thirst ; to keep the 
person and the dwelling clean, and to allow of no sinks close to the 
house, to admit no poultry nor animals within the house, and to 
keep it airy by ventilation. Where there are sick, let not the 
place be crowded. 

" Notwithstanding the best precautions, the Cholera may at 
times break out. The following are its symptoms, and the treat- 
ment to be pursued with perseverance and confidence : — 

" A person in good health may be suddenly attacked by Cholera; 
at first sickness, the eye-sight dimmed, then, after a shiver and 
rumbling in the bowels, vomiting and purging, with acute pains 
below the breast, under the ribs, and on the left-side, attended 
by quenchless thirst. If the patient be not quickly succoured, 
cramps ensue in the legs and arms, which become of icy coldness ; 
extreme weakness comes on, and a deadly paleness, — the whole 
body becomes cold, then a hiccough, and other signs of approach- 
ing death. 

" On the appearance of the first symptoms let medical aid be 



PROPOSED IN RUSSIA. 13 

immediately called ; but if that cannot be obtained, the treatment 
necessary is as follows : — 

" 1. Let the patient be warmly covered. 

" 2. Let his whole body be well rubbed with warm vinegar or 
brandy ; likewise his hands and feet and pit of the stomach with 
clear tar, or, if none can be had, with strong brandy. 

"3. Let the patient take, in frequent and small quantities, a 
warm and light infusion of mint, or of the essence of mint, one 
or two di'ops at a time, with sugar. 

" 4. If there be no abatement of pain or vomiting, a blister of 
mustard should be applied to the pit of the stomach. 

"5. If all the same symptoms still continue, and the patient be 
of a strong constitution, then apply leeches to the same place, 
twelve to twenty for an adult, and for children six to ten ; but, if 
of a weak constitution, let no leeches be used without the advice 
of a phj^sician. 

" 6. A warm bath, if ready and near, may be used with benefit ; 
otherwise a vapour-bath may be prepared at home thus :- — heat 
some stones or bricks, and over them place a bedstead with a 
netted bottom, upon which let the patient be stretched, well 
covered; then throw the vinegar upon the hot stones, whence 
steam will arise conducive to perspiration, aided by the frictions, 
which must not be discontinued. For want of this vapour-bath, 
place around and in contact with the patient, bags of heated sand 
or ashes. 

" Observations. — During the present epidemic no applications 
have been found so efficacious as strong friction, either with the 
naked hand, with a cloth, or with a brush, using clear tar, or 
some other irritant. The essence of peppermint may be used 
more freely than heretofore prescribed. 

" Great care must be observed during convalescence, for the 
Cholera is but too often followed by typhus fever .^^ 

The last accounts received from abroad which we shall cite re- 
specting the foreign progress of the disease are as follows : — 

Malta, August 1, 1848. — "The rapid approach of Cholera to 
our island has again compelled the authorities of the Health Office 
to pay attention to the safety of the island. Quarantine has 
been established." 

Egypt. — Letters from Alexandria, of the 22nd ult., announce 



14 quarantint; and 

that Cholera had manifested itself intensely at Cairo, and had 
also reached Tantah, a tovm on the Damietta branch of the Nile. 
Alexandria had hitherto been spared, and, as the malady was 
brought by pilgrims from Constantinople, several of whom were 
visited with it in the lazaretto of Alexandria, the correspondent 
infers from its not meeting there with the atmospheric condition 
necessary for its development, that the city had nothing to appre- 
hend from its effects. Ibrahim Pacha immediately gave orders to 
suspend all laborious works, and to supply the men engaged in 
them with wholesome food. The public establishments in Cairo 
were placed in quarantine. 

Berlin, Aug. 2. — A case of Cholera reported in the Charite 
Hospital yesterday has not excited any alarm, as it was of the 
kind usually exhibiting itself in indi^'idual instances at this time 
of the year. There is no intelligence of the disease having ap- 
peared at any point between this city and St. Petersburg. 

It was to be expected, that contemporaneously with the ap- 
pearance of the disease on the Continent, the subject of quarantine 
and coi^dons sanitaires should be broached. A report, however, had 
been presented to Parliament, in vfhich the Commissioners, after 
studying the history and peculiarities of the disease and partially 
discarding the idea of its communicability from person to person, 
suggested that quarantine should not be enforced. The following 
Order in Council will show how far this recommendation was 
adopted by the authorities, at the same time that it is an index to 
the anticipations predominant at the time at head-quarters : 

" A commun'calion has been received by the Commissioners of the Cus- 
toms' Department, through their secretary, from Mr. Greville, one of the clerks 
of the Council, stating that with reference to his communication, dated the 
15th of June last, directing all vessels arriving in the United Kingdom, having 
foul bills of health (with reference to Cholera), to be released from quarantine 
without any medical visit, providing no case of Cholera had existed on board 
any such vessel for a period of ten days previously to her arrival, he (Mr. 
Bathurst) has been directed by the Lords of the Council to state, for the in- 
formation of the Commissioners of the Customs, that it is the express desire of 
their Lordships that the before-mentioned regulation should still continue in 
force. Mr. Bathurst had also to state that he was now further directed by 
the Lords of the Council to inform the Commissioners that their Lordships 
are of opinion that instructions should be forthwith transmitted to the 
different ports in the United Kingdom, directing that, in the event of the 



CORDONS SANITAIRES. 15 

arrival of any vessel on board of wliicli a case of Cholera shall have occurred, 
such vessel shall be detained under the restraint of the quarantine until the 
clothing and bedding of the following persons shall have been thoroughly 
immersed in water, under the direction of an officer of the Customs — viz. : 
1. Of all persons who shall have died of Cholei'a on board of such vessel at 
any foreign port, or on shore at such port. 2. Of all persons who shall have 
died, or who shall have had an attack of Cholera, on board of such vessel 
during her homeward voyage ; and that, should any vessel arrive with Cholera 
actually on board, such vessel shall be detained under quarantine at her port 
of arrival until further orders from the Lords of the Council are received. 
In pursuance of this commiuiication from the Lords of the Council, with a 
view to prevent the introduction of Cholera into this country by vessels arriv- 
ing from abroad, express directions have been forwarded by the Commis- 
sioners to the officers of the Customs' Department at the several ports and 
places throughout the United Kingdom, as well as to the port of London, to 
take care that their Lordships' orders be duly obeyed." 

The policy or impolicy, the expediency or inexpediency, of 
having recourse to the laws of quarantine when there would appear 
to be an epidemic crisis prevailing in separate and distant parts, 
not only of Europe, but in different parts of the world, we shall 
not here discuss ; we shall simply record the history of this last 
visitation of the disease, and the measures which were at the 
eleventh hour recommended and prescribed by the Government 
and local authorities, to check its progress and mitigate its inten- 
sity, in the hope of deriving a moral lesson from such details, 
which will teach us to adopt such sanitary measures as will me- 
liorate the moral and physical condition of the poor ; and enable 
us to avail ourselves of such resources as may, under the blessing 
of Divine Providence, be placed within our reach to avert or 
mitigate the terrors of the pestilence which spreads sorrow and 
desolation throughout the land. 



CHAPTER II. 



The origin, nature, and causes of Cholera. 

Having thus far traced the history of the Cholera^ during- its late 
visitations abroad and at home^ and referred to the sanitary mea- 
sures which were so stringently called for to check its fatal pro- 
gress through the heart of our densely-populated metropolis, we 
now proceed to consider the opinions which have been entertained 
respecting the origin, nature, and causes of the disease : a course 
which appears to us more consistent with the duties of the his- 
torian than hazarding speculations of our own, which would only 
add to the many theories which already throw a fascinating and, 
we are afraid, fallacious light upon the path of medical practice. 

The derivation of the term Cholera was by Celsus referred to 
the words — XoAtj vilis, and peoi fluo — XoAepa, a bilious flux : the 
ancient physicians referring almost every disease to the flux, or 
reflux, or stagnation of the bile. Trallian and others assigned its 
origin to XoAa?, an intestine, with the same verb — implying 
thereby a bowel flux. The term, however, has been referred to 
a much earlier eastern source, and derived from two Hebrew 
words, '^n, signifying choli, sickness, and iJ'^, bitter, bad, or evil. 
Be this as it may ; the derivation of the word is less interesting to 
discuss than the early history and treatment of the disease. 

Hippocrates, in his "Epidemics," relates very well-detailed 
cases of Cholera ; and Paulus ffigineta gives a summary of the 
treatment which the Greek physicians conceived to be most 
successful. In one case described by Hippocrates, the disease was 



THE OPINIONS OF THE ANCIENTS. 17 

occasioned_, he affirms^ by unwholesome food ; such as pork im- 
properly boiled, pot herbs, summer fruits, &c. In another the 
patient drank hellebore in the juice of lentils, and vomited ; he 
became cold and was put into the hot hip-bath, where he regained 
his strength and recovered.* Aretseus defines Cholera to be a 
retrograde movement of the matters in the body upon the stomach 
and intestines, consisting of a discharge upwards and downwards 
of bile, which, if the disease proves fatal, becomes black ; and at 
the same time the extremities are cold, with profuse sweats ; pulse 
small and dense, constant straining to vomit and tenesmus. He 
also makes mention, among the symptoms of spasms and contrac- 
tions of the muscles in the legs and arms, of borborygmi, tormina, 
and syncope. The complaint, he says, is occasioned by continued 
indigestion, and proves fatal by superinducing convulsions, suffo- 
cation, and retchings. With regard to the treatment, he cautions 
us not to stop the discharge at first, but to encourage it by giving 
frequently some tepid water ; and when attended by tormina and 
coldness of the feet, to apply to the belly hot oil, and rub the 
legs to restore heat.f 

Oribasius, Actuarius, and Nonnus treat of the disease nearly in 
the same terms ; and Cselius Aurelianus gives a very complete 
histoiy of its symptoms. The bile which is vomited, he says, is 
at first yellow, afterwards green, and at last black. His treatment 
is veiy similar to that of Aretseus, viz., tepid water at the com- 
mencement of the disease to facilitate vomiting, sponges out of 
cold water applied over the stomach, or else cupping instruments 
with peat; aromatics, bread soaked in wine, and the like. He 
condemns Hippocrates for sanctioning the giving of hellebore ; 
and blames Diocles for recommending southernwood, which he 
remarks is a very harsh medicine ; and also for allowing milk, 
which he says is apt to grow acid. Cassius Medicus accounts for 
the coldness of the extremities and contractions thereof upon the 
supposition that they are occasioned by the vital spirits having left 
them, and been determined to the stomach. 

The disease among the Arabian physicians was also well known. 
Haly remarks that it consisted of a discharge of bile, and incul- 

* The medical profession is greatly Indebted to the Sydenham Society, for having published 
the collected writings of Hippocrates, Paulus (Egineta, Src, translated by the learned Dr. Adama, 
of Aberdeen. Hippocrates, vol. i., p. 310 — 329. 

t Paulus CEgineta, vol. i., p. 515. 



18 OPINIONS OF THE ANCIENTS. 

cates as a settled principle of treatment^ that when the strength 
continues good^ and the discharge not immoderate^ the vomiting- 
is to be encouraged by giving tepid water^ with oil of sweet 
almonds mixed. When there is great prostration of strength^ he 
directs us to sprinkle water on the patient's face^ to apply ligatures 
to his limbs, and to rub his feet and legs with a calefaciant oil. 
When the discharge cannot be got otherwise stopped,, he advises us 
to apply a cupping instrument over the stomach. Alsaharavias^ 
like the others, directs us to promote the vomiting at first by 
giving tepid water. Among his other remedies, he recommends 
an infusion of aloes and wormwood. Rhases recommends draughts 
of tepid water, the application of snow over the stomach, ligatures 
to the extremities, wine, and astringents. Avicenna, and most of 
the authorities, direct us to encourage sleep. Avicenna's plan of 
treatment is exactly the same as that of Rhases.* 

Celsus, to whom we have above referred, adds to the title of his 
chapter, "De Intestinorum Morbis,'' emphatically, " et primo de 
Cholera,'' because, he states, " it appears to be a disease common 
to the stomach and intestines." At the same time, he observes, 
"there is both purging and vomiting; besides which flatus, and 
tormina, and bile is ejected both upwards and downwards. The 
legs and hands are seized with involuntary contractions, and the 
patient is attacked with violent thirst and syncope ; from such a 
combination of causes," he adds, "we must not be surprised if 
the patient die suddenly ."f He then directs that vomiting should 
be encouraged; warm applications applied externally to the epigas- 
trium ; and if the patient be harassed by retching, stimulants are 
to be given. Should the patient be weak and the legs affected 
with spasm, wormwood is to be administered at intervals ; and if 
the extremities of the body become cold, they are to be anointed 
and rubbed with hot oil, to which a little wax may be added. 
The account which the ancients have thus given of all the charac- 
teristic features of the disease, — incessant vomiting, purging, 
muscular contractions and spasms, extreme prostration and collapse, 
— clearly indicate the symptoms which still identify the disease, 
and hence some of our modern writers have reasonably argued 
that its popular classification into English, Bilious, and Asiatic 

* Paulus ffigineta, x., vol. i., Book iii., sect. 39, p. .^)17. 
t " Celsus De Medicina," lib. iv., chap. xi. 



MODERN OPINIONS. 19 

or Malignant Cholera, only, in reality, implies the difFereut degrees 
of intensity assnmed by the same malady. " If we go beyond 
this," observes an intelligent observer, " we are inferring a dif- 
ference unfounded in fact, unsujDported by observation and legiti- 
mate deduction, and of injurious practical tendency." * 

Nevertheless many of our modern physicians have, in consider- 
ing the nature of the disease, doubted the propriety of the term 
Cholera being applied to it. Dr. James Keir, Knt., in his Treatise 
on Cholera, contends that the name is but ill-suited to express the 
nature of the epidemic ; and he argues, " that it ought to have its 
place in a system of Nosology, rather under the Comata or Adyna- 
miee than the Spasmi," and regarding it as a species of Apoplexy, 
or Asphjrxia, he proposes to designate it " Asphyxia Mephitica, 
alvi fluxus epidemica." Dr. John Wilson observes, that " although 
the term Cholera when applied to the disease under notice is 
derivatively erroneous, it has been so long adopted, and universally 
employed, that it would be vain, and perhaps useless, to attempt 
to alter it ; but the adjective appellatives coupled with it are so 
numerous and inappropriate, so confusing, and so likely to lead to 
unjust conclusions, that it is desirable to substitute for them a 
single significant epithet ;" and as a total want of bile in the fluid 
discharged from the stomach is one of the most striking and une- 
quivocal characteristics of the disease, he would give to it the two 
forms of the disease, Cholera Ahiliosa, and Cholera Biliosa.f 

In Dunglison's " Medical Lexicon," we have the synonyms as 
follows : — Cholera — Cholera Morbus — Cholera nostras — Cholera 
vulgaris — Sporadic Cholera — Cholerrhagia — Passio Cholerica — 
Felliflua passio — Morbus Fellifluus — Holera — Bilis fluxio, F. 
Cholera, Morbus Sporadique — Ch. Europeen — Trousse-galant. 
The higher degrees have been called Centro -gangliitis and Myelo- 
gangliitis. In India we have Spasmodic Cholera — Asiatic Cholera 
— Malignant Cholera — Indian Cholera — Epidemic Cholera — Pes- 
tilential Cholera — Asphyxia pestilenta — Choleric pestilence — 
Eastern Cholera — Cholera Indica — Cholera Epidemica — Typhus 
Bengalensis — Cholero Typhus — Ganglionitis Perijiherica et Me- 
dullaris — Hymeno-gangliitis — Panto-gangliitis — Cholerrhoea Lym- 
phatica — Psorenteria — Typhoid fever of India — Cholera Asphyxia 

* Fide Cj'clopsedia of Practical Medicine, art. Cholera. 
+ Treatment of Cholera in the Royal Hospital, Haslar. 

c2 



20 MODERN OPINION'S 

— Hyperanthraxis — Enteropyra Asiatica — Trisplanclinia — Tris- 
planchuitis — Hpemataporrhosis — Hsematorrliosis — Morbus Ory- 
zeus — Malignant Cholera — Convvilsive Nervous Cholera — Rice 
Disease — [because supposed by Tytler to be caused by damaged 
Rice] — Yr., Mort de Chien. 

Among the various causes which have been suggested as giving 
rise to the disease, some are curious, some absurd — and many, to 
say the least, are highly ingenious. A savant in Paris maintained 
that Cholera was caused by a peculiar acid pervading the air ; to 
correct which, as acid could have no greater enemy or corrector 
than Ammonia, he recommended that the heights surrounding 
Paris should be covered with batteries, and the cannons loaded 
with powder and balls of caoutchouc, filled with ammoniacal gas, 
which would thus be diffused through the atmosphere. 

It is stated by Dr. Chambers, that " the air in every country 
that has been scourged by the disease, has been unusually charged 
with electricity, as has been evinced by the extraordinary occur- 
rence of thunder storms and hurricanes at unusual seasons, and of 
frequent and severe earthquakes in the countries where such phe- 
nomena are common. ^^ Mr. Orton remarks, that " the air most 
favourable to the production of Cholera is in a highly rarefied state, 
and with respect to its electricity is negative ; a phenomenon which 
in ordinary times is a sure prognostic of storms.* Mr. Ambrose 
Blacklock, of the Madras Medical Establishment, in a pamphlet 
on Cholera, observes, " there is abundance of electricity in the air, 
but it is not free electricity, and cannot therefore act as a healthy 
stimulant to the respiratoiy surface, nor excite the spinal respira- 
tory bodies/^ M. Andrance, in a letter to the President of the 
French Academy, alleges that not only Cholera, but perhaps all 
the epidemics which from time to time afflict humanity, are caused 
by the decrease of electricity. In the '' Elements of Galvanism," by 
Mr. Wilkinson, it is held that the electrical state of the atmo- 
sphere exercises a powerful influence on the human body, and he 
maintains that the deficiency of the electrical fluid produces that 
remarkable relaxation of strength, which causes the general debi- 
lity of the human functions in those countries where the Sirocco 
prevails. Dr. Seth B. Watson contends, that the Cholera takes its 
rise from a malignant fluid existing in the atmosphere, and that 

* " Essay on the Epidemic Cholera of India." 



CONCERNING CHOLERA. 21 

therefore the disease has not the property of being transferred 
from one person to another by contact alone, and he proceeds to 
show four different ways in which the fluid may be received into 
the body; viz., by the skin, lungs, alimentary canal [taken in 
with the food], or through the tissues by disruption of their con- 
tinuity.* Dr. Alexander Knox, after enumerating the various 
opinions put forth, thus sums up his consideration of them : 
" The various exciting causes of Cholera," he observes, " may be 
arranged as follows : — 

" 1. — Direct irritants of the alimentary canal. 

" 2. — Atmospheric vicissitudes. 

" 3. — Various meteorological phenomena. 

" 4.— Malaria. 
" By Malaria is implied any noxious change occurring in the 
atmosphere, whether from chemical action, or additions to its 
ordinary constitution, from whatever cause arising; whether dis- 
solved, or merely floating in it : such as the emanation from 
decaying animal and vegetable matter, mineral effluvia, invisible 
animalculse, or morbific vegetable germs. 

" 5. — Several concurrent causes, to the exclusion of any 
single one. 

" 6. — An unknown cause." 
To the first of these. Dr. Alexander Knox implies assent. As 
to the second, " It is at once evident," he observes, " that the 
hygrometric, barometeric, and thermometric conditions of the atmo- 
sphere must have varied through their entire range in an epidemic 
which, in its progress both eastward and westward, has visited 
every part of the globe." 

To the third supposed cause Dr. Alexander Knox objects, "that 
the theory does not rest on the basis of any series of observations, 
and that, in the absence of facts, any speculations on the subject 
must be accounted purely hypothetical." 

Upon the fourth supposition he remarks, " That we should still 
be at a loss to accoimt for the prevalence of Cholera in particular 
parts of the country, to the exclusion of others ; or, what is still 
more remarkable, on one side of a street, one part of a barrack, 
or square, or in a single vessel in a fleet." 

Finally, Dr. Knox, in his recapitulation, says, " That the 

* " The Cholera at Malta in 1837. From the Kalian of Giuseppe Hilon, M.D." 



22 MODERN OPINIONS 

atmosphere is the medium through which the exciting cause 
of Cholera, whatever it may be, gains access to the living eco- 
nomy, appears certain; but beyond this the nature of the cause 
in question, although, probably, a specific virus, appears to be 
totally unknown/^ 

Professor Webb believes, that of all the causes of Cholera, an 
atmosphere impregnated with sulphuretted hydrogen is the most 
potent; and he observes, that India abounds in districts where 
this gas spontaneously issues from the ground. He adduces the 
following account of Indian superstition respecting the malarious 
origin of the Hill Cholic, or Choleroid Cholic of the Himalaya : — 
" The peculiar character of Hill Cholic is, however, the excru- 
ciating pain in the abdomen; sometimes so severe, that the 
patient is not conscious of anything else, and one agonizing 
shriek follows another till the strength is exhausted, and low 
moans express his last sufferings. The prevailing belief among 
the Puharrees in the hills is, that it is a demoniac seizure, and 
that the evil spirit springs suddenly upon the unwary from dark 
thickets, and shady fountains and water-courses especially. These 
last are full of decayed leaves and putrid \a ater. [It is worthy of 
remark, in reference to my opinion of its malarious origin, that 
men in perfect health who go to these water-courses, as to neces- 
saries, come back asphyxied Avith Cholic] Nearly all cases 
with them are fatal; their treatment being, to get five or six 
strong lusty fellows to shake out the devil, and frighten him by 
loud cries.^'* 

Dr. Keir, in considering the cause of the epidemic, remarks : — 
" It is still very obscure, quite as much so as that of the cause of 
the potatoe-rot, with which it may possibly have some connection ; 
and what we do know about it is little more than mere conjecture. 
There is some probability, however, for the opinion, that the dis- 
ease is induced by some deleterious vapour, or gas, perhaps pro- 
ceeding from the bowels of the earth, which, mixing with our 
atmosphere, and applied to the body, or inhaled into the lungs, 
exerts its deleterious influence on the blood and vital organs; 
sometimes so strongly as to prove almost instantly fatal; in 
others, at various intervals of time."t Dr. Adair Crawford con- 

* " Palliologia Indica; ov, the Anatomy ol'Indian Disease." Calcutta, 1S48. 
t " Practical Observations on the prevailing Eindemic, called Cholera." 1848. 



CONCERNING CHOLERA. 23 

ceives, that " It is difficult to draw any other conclusion from its 
in-egular^ capricious^ and rapid pi'ogress over large regions of the 
globcj than that Cholera originates from some latent influence of 
the atmosphere on the functions of animal life^ and that this 
influence is probably of a similar nature to those by which 
blights are produced in the vegetable kingdom." He adds^ — 
" That it is an epidemic propagated by atmospheric causes, and 
not by infection, seems now to be very generally admitted. This 
is the opinion of the medical profession in Kussia; so that all 
attempts to check its progress by quarantine regulations have 
been given up."* 

Dr. John Wilson remarks : — " Little, if anything, can be 
affirmed respecting its origin; but almost everything authentic 
in its history, progress, and phenomena, testify to its having 
a local source, and generally very limited scope of operation. 
Thus, it appears simultaneously in different, distant places, leav- 
ing intermediate places untouched. It attacks in one town a par- 
ticular district, street, or portion of street, beyond which it does 
not travel. In another town it shows itself among distant portions 
of the inhabitants, leaving long spaces unscathed. Again, while 
one town suffers severely from it, another in the neighbourhood 
has not a single case then, or thereafter; or the town which 
escapes this season falls fatally under its sway the next, when all 
the rest of the country is clear. These, and such circumstances 
as these, point as clearly as it is possible to point, at the endemic 
source of Cholera, although the essential cause of the disease 
cannot be ascertained." f 

Other physicans, however, view the question in a very dif- 
ferent light. Thus, Mr. Ambrose Blacklock,J Assistant Surgeon, 
Madras Medical Establishment, hazards the following opinions : — 
" The remote cause of Asiatic Cholera is the continual use of a 
diet deficient in the sulphur required to assist in forming sul- 
phuretted hydrogen to preserve the colon, or part of the body 
requiring sulphuretted animal matter in its normal electrical con- 
dition, and so giving rise to morbid ganglionic excitability. By 

* " Obsen'ations on the Asiatic Cliolera, during a Residence in St. Petersburgh, in 1848." 

t " Treatment of Cholera in the Royal Hospital, Haslar, during the months of July and 

August, 1849." 

X " The Leading Phenomena of Epidemic Cholera, with some plain Suggestions for its better 

Treatment and Prevention." 



34 



MODERN OPINIONS 



taking a skeleton map of the world^ and bi-usking with colour 
those parts where the staple articles of diet are deficient in sulphur, 
omitting only those parts which afford to man abundance of animal 
and leguminous food, we have in the coloured portions a fair view 
of the woi'ld as it is liable to epidemic Cholera. Or we may 
arrive at the same knowledge by inspecting a rough tabular view, 
as subjoined : 





Parts of the World. 


Prevailing Diet. 


Character 
of Diet. 


rs 
■3 

<u 
'0 




Asia 

North Africa . . . 
S. of Ireland . . . 
Manufacturing Dis- "1 
tricts of England J 
Coast Places 


Rice 

Rice and barley 
Potatoe 

Coarse bread, potatoe, oatmeal, ba- 
con fat, fish 
Fish 


Not sul- 
phurous 


r2 
'0 

'0 
U 

in 

CS 

P-i 

rH 
;-( 

ID 
'0 

-w 




Continental Europe -! 

North of Ireland . i 
Scotland .... 
All large towns . -j 
North America . 


Wheat, rye, barley, with a little 
leguminous food and animal food 

Oatmeal and potatoe, with a little 
leguminous and animal food 

Ditto ditto ditto 

Nearly similar diet. Most of the 
poor population even worse fed 

Partly animal, partly vegetable 


Only 
part sul- 
phurous 


South America . . 
South Africa . . . 
New South Wales . 
South Sea Islands 
Polar Regions . . 


Beef 

Beef and mutton 

Beef and mutton 

Pork 

Seal and whale 


Sulphur- 
ous 



However, it is here proper to observe, that in a note to the above 
Table, the author allows that he has only aimed at an approxima- 
tion to accuracy in his statement. 

Dr. James Bird observes,* that from the experience of the past, 
it would appear that the disease, " even in India, is of endemico- 
epidemic origin, and arises from many concurrent causes and con- 
ditions, which alter the chemical constitution of the blood, and 
render it incapable of receiving those respiratory changes in the 
lungs, necessary for the production of animal heat, and the main- 



"* "Contributions to the Pathology of Cholera, embracing its History, Modifications, Stages, 
and Treatment, as the Disease appeared in the Bombay Presidency, from 1818 to 1842." 



CONCERNING CHOLERA. 25 

tenance of the nervous functions. These causes and conditions 
may be briefly enumerated, as deficient and impure food ; sleeping 
in crowded, damp, and ill-ventilated apartments ; anoemia, or im- 
poverished conditions of the blood, arising from previous disease, 
dissipation, and want ; deleterious influence of malarious emana- 
tions and animal efiluvia; close, humid, and negative electric con- 
ditions of the air; mental anxiety, and depression; and a general 
epidemic constitution of the atmosphere. But while the disease 
originates from these several causes, it manifests, in its progress 
from place to place, that it can attach itself to masses of the 
people, and can, under certain conditions, be disseminated from 
person to person." 

Dr. Andrew Buchanan ascribes its probable remote cause to a 
miasmatic poison, diffused through the atmosphere in certain 
situations, and received into the lungs by respiration.* 

M. Th. Doorjak, Medecin de la Cour Imperiale, says, "D'apres 
toute probabilite, le principe morbifique est repandu dans Fatmo- 
sphere ; il est vraisemblable qu^il agit sur Forganisme tant par la 
respiration que par Fabsorption cutanee ; son action seule est tres 
lente sans la co-operation des organes de la digestion ; quant a sa 
nature, il parait qu^il ressemble a Feffluve des marais et des sout- 
terains ; quant a sa maniere de propagation, il a beaucoup d^ ana- 
logic avec la scarlatine. Les animaux mammiferes, ainsi que les 
oiseaux, paraissent ressentir son action deletere, quoique dans un 
moindre degre." f 

Dr. W. L. McGregor J observes, that "the remote exciting 
cause of Cholera is attended and preceded by a peculiar state of 
the atmosphere, and the remark is often made, that Cholera is 
likely to occur when no rain has fallen for a long interval, and the 
weather is close and oppressive. This condition indicates a posi- 
tive state of the atmosphere as regards electricity, and a negative 
condition of the earth and its inhabitants. People feel languid, 
and many unwell ; but still there is no actual disease or epidemic. 
If under these circumstances any cause extracting still more elec- 
tricity from our bodies should exist, we can easily see that some 
terrible disease must ensue. Such occurs in Epidemic Cholera. 

* "Observations on Malignant Cholera, &c." 1848. 

t " Memoire sur le Developpement, les Causes, et le Traitement, etc." 

t " Treatise on the Blue Epidemic Cholera." Delhi. 



26 MODERN OPINIONS 

A stratum of air near the earth^s surface may be negatively elec- 
trified, that is, deficient in its due quantity, and passing along the 
earth, abstract electricity from the human race who come within its 
influence, provided the individuals be predisposed ; for it is well 
known, that many escape, though living under the same roof with 
those afi"ected ; and even a little elevation will serve to remove indi- 
viduals from the epidemic. This, then, appears to be the great 
remote existing cause of blue epidemic Cholera." 

Dr. Evans, of Rush Medical College, U. S., after reviewing the 
miasmatic, animalcular, cryptogamous, atmospheric, telluric, elec- 
tric, ozonic, and carbonic theories, and pronouncing them all 
unsatisfactory, observes : " Cholera is subject to no boundaries 
except those that prevent human intercourse. We find it in the 
densely-populated city, on the dreary desert, and mid western 
prairie. Laying low the inhabitants of the princely mansion, the 
cottage, and the Indian wigwam. Traversing all climates, from 
the scorching Indies to the regions of perpetual snow; and ex- 
tending from the celestial empire of the East to the golden valleys 
of California in the Westj attacking alike the indigent and 
the affluent, the filthy and the cleanly, the reckless debauchee, 
and the prudent valetudinarian. The young and the old, the black 
and the white, the yellow and the red man. In the dreary home 
of the latter, on the extensive plains that stretch out from the 
Missom'i river to the Rocky Mountains, it is now committing its 
fearful ravages. And as if to put the blush upon our boasted 
knowledge and philosophy — our enlightened mode of investigation 
— our learned and logical reasoning — from his awn observation he 
announces to his comrades what its history indicates as the true 
mode of its propagation, and commences to take vengeance upon 
the white man for bringing it among them.''* 

Dr. John Webster, in a paper read before the Westminster 
Medical Society, Oct. 6th, 1849, holds that the causes may be 
classed under the heads — Atmospheric, Local, Individual, and 
Exciting ; but that much yet remains to be ascertained, so as fully 
to explain the various phenomena. 

In a popular and very ably-conducted journal, we find an 
article, entitled " General Considerations on Epidemic Diseases," 

* " Observations on the Spread of Asiatic Cholera, and its Communicable Nature." Chicago, 
1849. 



CONCERNING CHOLERA. 27 

which contains the following observations^ well worthy of con- 
sideration : 

" Blending now the two propositions that we have been illustrating with 
regard to epidemics, our notion of these terrible occurrences would assume 
the following theoretic form : — That occasionally, at particular spots of the 
earth's surface, there takes place a sudden derangement of the aggregate of 
atmospheric or telluric conditions necessary to human life; that sometimes 
this derangement is local and temporary ; but that at other times it extends 
itself in some m3^sterious way, creeping slowly in the shape of an impalpable 
morbific influence, and generally in a westerly direction round the earth and 
through its atmosphere, until the whole world is affected ; those spots suiFering 
most severely, however, that present to the advancing morbific influence cer- 
tain combinations of circumstances that specially attract and hold it. Still, 
however, all this is comparatively vague ; and the questions naturally arise — 
What is the particular derangement, alteration, or reduction of the terres- 
trial condition of human life that commonly originates epidemic disease ; and 
is the derangement, alteration, or reduction the same in kind in all epi- 
demics, and only different in degree ? How, too, does the derangement or 
morbific influence spread and extend itself; and what detei'mines the rate of 
its dissemination? 

" Such questions as these our science is, and will long remain, too meagre 
to answer. In the talk, however, that now prevails on the subject of epi- 
demics, two different modes of conceiving the physical character of such 
influences are confusedly discernible. In speaking of cholera, typhus, &c., 
some theorists habitually make use of such phrases as ' poison in the atmo- 
sphere,' 'disseminated virus,' ' cholera-miasm,' &c. At the bottom of this 
mode of speaking there evidently lies the idea that epidemics are caused by 
the positive addition of some unusual and noxious ingredient — necessarily of 
a gaseous kind — to the normal atmosphere. The quantity of this ingredient 
may be so small as to escape the most delicate tests , or, as Dr. Prout's ex- 
periments on the weight of a given bulk of air during cholera (thermometri- 
cal and barometrical conditions being the same) would seem to indicate, it 
may in some cases be quite appreciable. Under this ' poison-theory ' may 
be also included that variety of the same mode of thinking which, without 
supposing the addition of any positively new ingredient, yet svipposes such 
a change in the relative proportions of the established constituents of the 
atmosphei-e (oxygen, nitrogen, carbonic acid, water, &c.) as would convert 
the wholesome fluid into a veritable though slow poison. A sudden addition 
or diminution of the quantity of moisture, for example, might have some- 
thing of this effect. In either case the theory is, that a contaminated local 
atmosphere may extend itself, and that, being breathed by the hmgs of men, 
it acts on the system by some process of vital chemistry, so as to produce 
death. Thus, of Asiatic cholera, the Sanitary Commissioners say that, 'it 
appears to be caused by a poison diffused through the atmosphere, which acts 
with peculiar intensity on the mucous membrane of the alimentary canal.' 



28 MODERN OPINIONS 

Somewhat different from this theory is that which seeks for the cause of epi- 
demics not in a change of the ponderable constituents of our atmosphere, so 
much as in a change in the activity of the imponderable influences or forces 
that hold the whole earth together, and particularly in a change of its electri- 
cal conditions. The two theories are not necessarily inconsistent ; for any 
change, for example, in the composition of the atmosphere hanging over a 
marsh or lake, would necessarily involve some change in its electrical condi- 
tion ; and, vice versa, a sudden electrical change in such a case would thrill 
like a re-arranging influence through the whole mass of atmospheric atoms. 
Cholera or plague may consist, therefore, in an envenomed or altered atmo- 
sphere ; and yet the characteristic and dead y fact respecting this envenomed 
and altered atmosphere may be in the abnormal electrical character that is 
thus given to it. In fact — though to speak of cholera or plague as 'something 
electric,' or a ' derangement of the telluric electricities,' is equally vague as 
to speak of it as a ' poison in the atmosphere' — such a leaning towards the 
electric view of the case seems a better intellectual direction."* 

In tlie metropolitan journals, and daily newspapers, every qucestio 
vexata respecting tlie origin, course, nature, and treatment of the 
prevailing epidemic, was boldly discussed ; and, armed to the teeth, 
with their vizors do^m, many of our busiest practitioners entered 
the arena of controversy, hazarding the most conflicting and op- 
posite opinions; nevertheless, in this anonymous contest, much 
ingenuity, scientific knowledge, and practical information, were 
frequently displayed, although the non-professional portion, or 
great majority of the public, could scarcely appreciate the merits 
and bearings of the dijBFerent doctrines which were propounded. 
The apology for thus obtruding disquisitions strictly professional 
upon the public was obviously the wide and ^dtal interests which 
were at stake affecting all classes of society, which could not be 
appealed to by the restricted channels of medical literature. 
During so great a national calamity, the most learned and punc- 
tilious physician is justified in addressing himself duectly to the 
popular organs which disseminate information through all classes 
of society. Hence, at this calamitous period, our newspapers 
frequently contained special articles and paragraphs, which were 
of great scientific interest and practical value. To return, how- 
ever, to the histoiy of the speculations which were advanced in 
order to explain the origin of Cholera. A correspondent in the 
Morning Chronicle, signing himself, "Anti-Zymosis,^' contended 
that " during the prevalence of Cholera, the atmospheric elec- 

* " Chambers's Edinburgh Journal," 1849. 



CONCERNING CHOLERA. 29 

tricity possesses but one-half of its usual intensity/' and con- 
nected with this fact the important observation that the proximate 
cause of Cholera is the tendency of all animal substances to 
putrefaction in an atmosphere deficient in ozone, an oxide of 
hydi'ogen, the product of electrical action, and the amount of 
which in the atmosphere varies in an exact ratio with the electrical 
intensity. During three months, when the Cholera most pre- 
vailed, it was remarked that not the minutest quantity of ozone 
could be detected by chemical tests in the air of London. Bir- 
mingham, Berlin, and Lyons, having escaped the pestilence, it was 
suggested that, as ozone is generated during combustion, where 
large fires are kept up, as in those places, a vast quantity of ozone 
might thus be produced, which would explain the exemption of 
such localities from Cholera. To this view of the case, " Medicus," 
in the same journal, opposes the following: — If ozone is "pro- 
duced by an electrical state of the atmosphere, and Cholera results 
from ozone being deficient, and influenza from its being in excess, 
then, as atmospheric electrical action must be going on over wide 
districts, the plus or minus presence of the ozone produced by it 
should be manifest by the Cholera occurring as widely as the range 
is of the atmospheric influence. Yet we find the Cholera prevails 
in a locality whose square is only one or two miles, while whole 
towns and villages surrounding it, and with every decomposing 
agency going on in them, are wholly exempt from its attacks, and 
this not merely for a season, but invariably and enduringly.'' 

Another correspondent in the same journal recollects reading, 
that at a period (fifteenth or sixteenth century) when Europeans 
fed upon rye bread, owing to a disease which developed itself in 
the grain, a very fearful sickness, followed by deaths innumerable, 
supervened. This was, of course, merely the well known " Er- 
gotism," of which later times have presented some examples. 



CHAPTER III. 



Novel speculations on the cause of Cholera promulgated in the last epidemic. 

During tlie prevalence of the late epidemic^ some opinions were 
broached respecting the cause and mode of communication of 
Cholera^ which are entirely novel. The truth or error of these 
opinions remains yet to be decided ; but a short account of them 
appears necessary. 

Whatever may have appeared to be the opinions held by medical 
men respecting the mode of communication of Cholera,, the debate 
has, in great measure, been limited to the question, whether any defi- 
nite principle or agent capable of exciting the malady in a person 
previously healthy, was given off from the body of a person affected 
with Cholera, or whether the active cause did not rather spread by 
virtue of some innate force or power of increase, which was in no 
wise connected with the systems it affected. According to either 
supposition, or according to the view which regarded Cholera as 
the result of some changed condition in the electricity of the 
earth and air, or of some alteration in the composition of the air, 
the atmosphere was supposed to be the channel of communication. 
An entirely different opinion has been lately advocated. It has 
been attempted to show that the atmosphere is not to blame in 
any way; that it, neither by changed composition, or by altered 
properties, or from superadded elements or principles, has any- 
thing to do with the diffusion of Cholera. Not air, but water, is 
said to be the medivim by which the Cholera agent spreads. Those 
close and ill-ventilated hovels — the abodes always of fever, and at 



RECENT OPINIONS. 31 

intervals of Cholera — are supposed to be ravaged by the latter, not 
on account of the foetid atmosphere, laden with impurities and 
effluvia from person and from habitation, but simply because the 
active cause of Cholera has found its way into the drinking-water 
of the inhabitants, from some accidental admixture with the intes- 
tinal discharges of persons affected with Cholera. Whatever may 
be the fate of this opinion — and we strongly suspect it is not 
based on very stable arguments — it is impossible to deny that it is 
a new featm*e in the discussion on Cholera, and that it has been 
argued with great skill by its able proposer. 

The facts which originally led Dr. Snow to the opinion alluded 
to, are the following : — It has been long known that in every epi- 
demic of Cholera, curious instances occur in which the disease 
appears to be localized. It attacks heavily the inhabitants at one 
spot ; it spares entirely others, who may yet be in close proximity. 
The explanation of this circumstance has been sought either in 
some differences of locality or mode of living, or in some peculiar 
want of predisposition on the part of those persons who escaped 
untouched. Occasionally, however, these explanations have not 
been applicable to the circumstances of the case ; and then the dif- 
ference of spread has been referred to the " capricious action " of 
the choleraic virus, and has been included among that extensive 
series of phenomena which seemed to defy, for the time, all 
arrangement and all law. A case of this kind occurred to Dr. 
Snow. Two small courts in Horsleydown are situated close to 
each other ; in both courts the houses are built exactly alike : the 
back of one row joins with the back of the other, and between the 
two are necessaries and cesspools, common to both; the inhabit- 
ants of both rows are of the same condition in life, follow equiva- 
lent trades, and have analogous habits. Yet one of these courts 
was, in the late epidemic, severely affected by Cholera, while the 
other, at the time, nearly escaped. The most obvious differences 
between the two courts are, that one is larger than the other, con- 
taining fourteen houses instead of eight, and is placed on somewhat 
lower soil. Yet these slight differences did not appear to Dr. 
Snow sufficient to account for the localization of the disease in one 
place, and its non-extension to the other. He resolved then on a 
more minute investigation, and, after some inquiry, discovered 
that the two courts differed in their supply of water. In the court 



3.2 RECENT OPINIONS. 

in which Cholera prevailed^ the water was drawn from an impure 
well ; it was most offensive, and contained evidently decomposing 
organic matter, in large quantity. In the other court, the water 
was pure and fresh. 

Admitting that the difference in the water supply was the real 
and true cause of the difference in the attack of Cholera, two 
explanations suggested themselves : — the impure water may have 
been a determining cause ; a something added to the other causes, 
special and accessory, and determining their action. The inhabit- 
ants of the other court, equally liable from situation and bodily 
predisposition, were yet not exposed to this additional, and, as it 
were, immediate exciting cause, and consequently escaped. This 
explanation is not, however, adopted by Dr. Snow. He ascribes a 
more immediate and direct influence to the impure water. Not 
only was it, according to him, an assisting and accessory agent, 
but it was the principal, and, in fact, the only cause of the 
Cholera. The water was not, he supposes, a simple noxious agent, 
giving strength to that which was powerless without it, but was 
actually the sole and independent source of the disease. In fact. 
Dr. Snow abandons as illusory, and condemns as untrue, all specu- 
lations which have been rested on presumed atmospheric impurity, 
and believes that the water itself held the toxic agent. In order 
to explain how the active cause of Cholera thus passed into the 
water of this well. Dr. Snow advances the hypothesis that the 
intestinal fluids so largely excreted in Cholera, contain the special 
poison. These fluids, accidentally or from ignorance, were per- 
mitted to mix with the water of the well ; persons drinking this 
water then received directly into their alimentary canals some 
portion of this active principle, Avhich immediately began to exert 
its baneful influence. In order, however, to account for the first 
case which occurred in the court. Dr. Snow is compelled to sup- 
pose that the water was contaminated before it entered the well : 
afterwards each case added fresh portions of choleraic poison to 
the ali'eady unwholesome and poisonous fluid. 

In support of this case. Dr. Snow cites a second one ; viz., the 
instance of Albion-terrace, in some houses of which occurred a 
frightful mortality from Cholera; while other houses, and the 
immediate neighbourhood, entirely escaped. On investigation. 
Dr. Snow found that here also there had occurred a contamination 



CONCERNING CHOLERA. 33 

of the water from sewage matter in those houses the inhabitants 
of which were attacked^ and not in the others. This case, how- 
ever, rests on more disputable evidence; other causes were here 
decidedly in operation ; and the statements made by Dr. Milroy 
would rather lead to the conclusion that the contaminated water 
was merely an accessory, and not a very important cause. 

Dr. Snow has endeavoured to apply his hypothesis to the course 
of the Cholera in England, or has rather singled out such facts in 
this coiu'se as seemed to accord with his view. He has not been 
able to bring forward any facts which will bear comparison in 
point of weight with those given above. 

Dr. Snow has not attempted to specify the cause of Cholera 
m water, which has, however, been done for him, as will be 
presently mentioned. Nor has he any other grounds for the 
supposition that the cause of Cholera is given off from the in- 
testinal surface, except that such an opinion might explain the 
diffusion of the disease by the medium of water, and is in accord- 
ance with the opinions he entertains regarding the primary seat 
of Cholera being the gastro-enteric membrane. 

At present these opinions of Dr. Snow's can be considered only 
ingenious speculations, which must be submitted to the test of 
careful inquiry. 

An opinion somewhat similar has been advanced by M. Pellarin, 
who has forwarded to the French Academy of Medicine many 
documents relative to the spread of Cholera. These documents 
have not yet been made public, but M. Pellarin appears to consider 
that the discharge of Cholera contains the contagious principle, 
and that it is from the reservoirs of sewage, and from the matters 
of the drains into which such discharges have passed that the mor- 
bific principle rises. But M. Pellarin does not appear to consider 
water the only or even the common medium, or the mode in ques- 
tion the only mode of spread. 

A singular episode in the history of Cholera, seemed at one time 
to accord -with the opinions of Dr. Snow. This was the observation 
made by Drs. Brittan and Swayne, and confirmed and extended by 
Dr. William Budd, of the existence of peculiar microscopic bodies 
in the Cholera discharges, and which bodies were held by Dr. 
Budd to be some species of fungi. The bodies described and figured 
by these gentlemen, were, however, not all of the same kind; they 

D 



34 RECENT OPINIONS 

had included apparently, under the supposition that the several 
forms were phases of evolution or involution, particles of foreign 
matter, such as food, and medicines, or organic matter thrown out 
fi'om the intestinal surface, or specimens of fungi rapidly formed 
in the appropriate nidus which the Cholera discharges ajSForded. 
The following enumeration of the microscopic forms figured by 
Di's. Brittan, Swayne, and Budd, is given in the able Report of 
the College of Physicians : 

" 1. Rings -wliich enclose a free area and which often are broken. These 
are usually of minute size, according to Drs. Brittan and Swayne, but occa- 
sionally lai-ge, according to Dr. Budd." 

These l*ings appear to be formed by altered vegetable, spiral, and 
annular tissues ; sometimes also by particles of chalk, and perhaps 
also by altered animal nuclei. 

" 2nd. Globular or oval cells, chiefly of the middle size, which have a 
thick wall with numerous small eminences on its surface, and which contain 
a granular mass in some instances separated by a clear space from the wall 
of the cell." 

These are considered by the Committee to be identical with the 
spores of various species of uredo. 

"3rd. Bodies having apparently the form of discs, with thick elevated 
and somewhat irregular curved margins ; the central area flattened and 
obscurely granular. They have generally a yellowish or pale brown tint, 
which varies in depth with the colour of the fluid containing them. These 
are the most peculiar of the bodies found in Cholera, and differ from the rest 
in being more or less soluble in ether." 

The Committee state that these are evidently not cells, nor have 
any organised structure which can give them any claim to be re- 
garded as living organisms. The Committee are disposed to con- 
sider them as of a fatty nature. 

"4th. Lirge broken cells, having apparently homogeneous membranous 
walls, and containing some well-defined oval bodies." 

The Committee think they may be starch or bran cells. 

The labours of the Committee of the College of Physicians 
not only prove that the bodies figured by the observers before 
referred to, were of heterogeneous nature, but they also proved, that 
all these bodies, even those included. under the 3rd head, were not 
peculiar to tlie discharges of Cholera, being absent frequently from 
such discharges, and being present in the discharges of other 
diseases, such as those of typhoid fever, a fact first pointed out by 



CONCERNING CHOLERA, 35 

Dr. Jenner. These circumstances proved, tliat whatever might be 
the nature of some of the bodies indicated by Drs. Brittan and 
Swayne, and their real source is even now not absolutely deter- 
mined, these bodies could not be considered as essential to Cholera. 

At the time when it was supposed that these so-called " cholera 
fungi," or "annular cells/' were universally present in cholera 
discharges, a still greater interest was attached to the statement, 
by the announcement of the discovery by Dr. Brittan, of similar 
bodies in the air, and by Dr. Budd of similar bodies in the water, 
of Cholera districts. This observation of Dr. Budd, agreeing as 
it did with the views then newly promulgated by Dr. Snow, seemed 
to give strong support to the hypothesis of this latter gentleman, 
and also to gain itself confirmation from Dr. Snow's facts. The 
observations of many gentlemen, however, both in London and 
Edinburgh, have proved that these bodies are not universally or 
even generally found in the water of infected districts ; and the 
discovery of " annular bodies " in the air has not been confirmed 
by a single individual. 

While, therefore, the merit remains to Drs. Brittan, Swayne, and 
Budd, of having pointed out as an occasional element in Cholera 
discharges, certain bodies which had previously been overlooked, 
it does not appear that these bodies stand in any very intimate 
relation with the disease, in the progress of which they occur. 

Another novelty, as it may be termed, which has gained some 
advocates in the last epidemic, is the application of the ozone 
theory to explain the difi"asion of Cholera. The principle called 
"ozone," whether it be an allotropic condition of oxygen, or a 
new combination of oxygen and hydrogen, was supposed by 
Schonbein capable of producing catarrhal symptoms ; and he sug- 
gested that as it is formed in great quantity during certain condi- 
tions of ten-estrial magnetism, it might, by being generated in 
unusual quantity, and by being widely diffused, cause those epide- 
mics of Influenza which every now and then course over the globe. 
This hypothesis, for it was no more, and has never yet been 
more, was seized upon by certain rash speculators, and applied 
at once to Cholera. Strange to say, the men who thus endea- 
voured to make an almost unknown agent, of whose composition 
and nature they knew little, account for the existence of a 
disease, of whose phenomena and observed developments they 

D 3 



36 RECENT OPINIONS CONCERNING CHOLERA. 

knew nothings were men of some reputation in science^ who 
would, had they been deahng with matters with which they 
were conversant, have jealously scrutinized eveiy step and every 
proposition which they made or deduced. But when they were 
dealing* with some of the most obscure natural phenomena 
which the complex and abstruse science of medicine has to inves- 
tigate, these very philosophers betrayed the credulity of an uneda- 
cated person, and the haste of an unwise one. The doctrine of the 
production of Cholera by ozone has not a positive fact in its favour, 
and is strongly opposed by many observations, which the defenders 
of the theory referred to have prudently ignored. 

The hypothesis of electrical changes producing Cholera at once, 
and not through the medium of ozone, has been already alluded to. 
This is no new "idolum," but a very old one. Some of those 
who witnessed Cholera in its terrible outbreak in India, from 1817 
to 1823, were ready enough to fall back on some hypothesis of an 
electrical cause when they found their common explanations fail 
them. The present epidemic has in reality added little to the 
observations then made. The inactivity of electrical machines, 
which has been noted at some places, as at St. Petersburg and 
Paris, has not been noticed at Stettin, nor, we believe, in London. 
'Whether changes in the terrestrial and atmospheric electricity have 
any casual relation to Cholera, could not be for a moment affirmed 
by any one who will apply to this question the ordinary rules of 
scientific evidence, and not regard it Avith a mind disposed to 
receive at once any assertion which sounds imposing and knowing, 
but may be, for anything the evidence says to the contrary, really 
incorrect and scientifically worthless. 

It would be useless to pursue this chapter further. The only 
new suggestion respecting the cause of Cholera made in this 
country of any importance, is that of Dr. Snow, and the value 
of this is as yet unknown. The electrical hypothesis waits now 
as formerly for positive and authentic facts by which it may be 
approved or condemned. Nor are we disposed to agree with the 
able editor of Chambers' Journal, that the leaning towards this 
hypothesis is " a better intellectual direction." 



CHAPTER IV. 



The dwellings of the poor a source of Cholera. 

Haying referred already to some of the causes of Cholera^ we now 
consider it necessary to notice emphatically one cause whichj 
during the late epidemic^ appears to have added strength to the 
disease, and to have rendered it doubly fatal : we mean the state 
of the dwellings of the poor. To most persons the very name 
of " home " has associated with it some of the tenderest remi- 
niscences ; but hoAV sad the reflection that the poor man's home 
should be infested with all the elements of disease and death ! 

It is well known to the medical profession that the health of 
working men is more precarious than of individuals belonging 
to the affluent classes of society ; and statistics incontestibly 
prove, that as " money purchaseth all things,'' so it may be 
employed with effect to ward off disease, and thus prolong, 
in the aggregate, human life. A^Tiatever may have been the case 
in ancient times, death does not, in the nineteenth century, visit 
with equal step the rich man's mansion and the poor man's 
cottage. The rich, born and nurtured in the " lap of luxury and 
ease," are protected from every evil wind that blows ; the poor, 
from their cradle to their grave, have to contend against exposure 
to causes inimical to health and the duration of life, the fatality 
of which is aggravated by the cupidity or ignorance of those 
who might provide shelter for the houseless, and cleanly and 
healthful dwellings for the lower classes. In making this state- 
ment, we would not have it supposed that even if our sanitary 
laws were as perfect as it is possible for human governments to 



38 THE DWELLINGS OF THE POOR 

make thenij a higher rate of sickness and mortality would not 
prevail among the poor than among the rich ; all that is 
intended to be conveyed is, that with improved sanitaiy laws there 
would be less sickness amongst the poor, and the mean duration 
of human life would be considerably increased. Epidemics have 
always committed the greatest havoc among those from whom 
poverty has Avrested the shield which could most effectually resist 
the shafts of disease. This was the case in the late visitation of 
the Cholera ; for while there were occasional instances of indi- 
viduals belonging to the " better classes of society " succumbing 
to the disease, it was from among the artizans it selected the 
majority of its victims. 

In passing through London, the most supei-ficial obsei-ver can- 
not fail to notice that squares and streets are built with a 
scrupulous regard to the different ranks of society. The courtly 
part of the metropolis is distinct from the commercial ; while in 
each we can descend from broad thoroughfares, flanked on each 
side by well-built houses, to narrow lanes, squalid courts, and 
filthy alleys, where the tenements are infinitely varied as regards 
condition, size, and plan. Here the victims of poverty are 
huddled pell-mell together — some pursuing an honest vocation for 
their daily bread; others appropriating to themselves whatever 
they may chance to captm'e without detection ; others living upon 
the proceeds of human lust — all of these WTL-etched beings render- 
ing their moral, as degraded as their physical, condition. The 
mechanic, who has vv^ages to afford it, occupies the respectable back 
street ; in the next the labom'er, with more limited means ; while 
thieves, beggars, and prostitutes take refuge in the various 
" rookeries " open for their reception : 

" I turn'd into an alley 'neath the wall, 

And stepp'd from earth to hell ! — The light of Heaven, 

The common air was naiTow, gross, and dim ; 

The tiles did drop from the eaves ; the unhinged doors 

Totter'd o'er inky pools, where reek'd and curdled 

The offal of a life. 

Shrill mothers cursed; wan children wail'd; sharp coughs 

Rang through the crazy chambers ; hungry eyes 

Glared dumb reproach, and old perplexity, 

Too stale for words ; o'er still and webless looms 

The listless craftsmen through their elf-locks scowl'd." 



A SOURCE OF CHOLEKA. 39 

In years gone by, the rich were bhncl to the dangers they 
created by thus thrustmg together and concentrating large masses 
of poverty and -wretchedness; science, however, has recently 
couched their diseased eyeballs, and light has penetrated them. 
The capitalist who speculated in bricks and mortar for the use of 
the labouring population, took nothing into his estimates but the 
rate per cent, for the money invested. Provided this was good, 
the landlord cared nothing foi epidemics, or pauperism, or crime, 
— frightful evils, either produced or aggravated by contempt 
for the domestic comforts of the poor. Before the Legislature 
interfered, cottages were erected upon undrained swamps ; mere 
holes were dug, either in or out of the houses, for the reception of 
human excreta3 ; rooms were foiined hardly high enough for a 
man of ordinary stature to stand upright, and where the air and 
light of heaven were allowed but partially to enter; while to 
these dwellings the wretched inhabitants had to make their way 
through nnpaved streets, almost impassable from mud and filth. 
How true is it of modern London, as Juvenal tells us of ancient, 
dechuing Rome : 

" Nos urbem colimus tenui tibicine fultam 
Magna parte sui : nam sic labentibus obstat 
Villicus, et veferis rimae contexit hiatum, 
Secures pendente jubet dormire ruina." 

In the more ancient parts of the metropolis we find old and 
dilapidated houses made profitable to the owners, by being let as 
lodgings for the poor. In these places the inmates have to make 
then way to their various apartments up broken staircases, black 
with the long accumulation of dust and dirt. The rooms them- 
selves are ill-lighted, badly ventilated, dilapidated, and swarming 
with vermin ; and from these combined causes the atmosphere is 
loaded with impurities of a most ojBFensive nature. 

" The air breathes upon us here most sweetly, 
As if it had lungs, and rotten ones. 
Or, as 'twere perfumed by a fen." 

In nearly all these ancient dwellings a cesspool in the cellar 
serves the double purpose of receiving the excretse and of generat- 
ing diseases. If the premises have drains they are of the most 
barbarous construction, either ascending or running on a dead 
level to the sewer. Most of the old drains are square, made of 



40 THE DWELLINGS OF THE POOR 

brickbats, and covered with slates — or have no covering at all. 
As a natural consequence large quantities of solid matter are 
deposited in the drains, and only a portion of the liquid sewage 
reaches the street. The bricks, being soft, absorb a large propor- 
tion of the fluids, and the surrounding earth takes from the sur- 
charged bricks, the moisture. As the di"ains frequently become 
choked, the sewage water of the house finds it way in larger quan- 
tities through the bricks under the floors, and forms large pools. 
Through these ill-constructed conduits the rats also from the main 
sewer make their way, and add to the nuisance. 

In these "homes of the poor" we find every room crammed 
with human beings, and not unfrequently the larger the family 
the smaller the apartment they occupy, because the father has 
less means at his command to pay for better lodgings. In 
the day the rooms are alternately used as washing places, kitchens, 
drying stoves, and workshops; at night they are all dormitories, 
in which many human beings sleep, either on a bed or on 
the floor. Lord Ebrington gives a graphic description of the 
dwellings of the poor in the neighbourhood of Golden-square. 
" I visited,^' he says, " this quarter, in company with Mr. Toyn- 
bee : it is one inhabited by the most respectable of the labouring- 
classes. Suff"ering, yet not degraded, they all received us with 
courtesy, and took kindly our few words of sympathy. Several, 
when asked what they earned, and what they paid for rent, owned 
to poverty; but none either begged or hinted for money, — they 
evidently did not expect any, and I offered none. They were all 
deeply sensible of the misery and sickness brought upon them by 
the condition of their dwellings, the impossibility of keeping them 
clean and tidy, and by the fetid smells, to which even habit had 
not reconciled them ; but they never murmured, nor spoke un- 
kindly of any one. These families, for the most part, have but 
one room, about twelve feet square, in which they sleep and live, 
and some carry on their trades besides ; I found them full of 
steam, from clothes hung up to dry across the room, after having 
been washed — many of them successively in the same water, owing 
to its scarcity. In one, besides, there lay a child, dead five days : 
lue did not see one healthy face, either of adult or child. Many 
children were ill, some with measles, some with fever; many with 
scrofula, which had covered them with wounds. In every family 



A SOURCE OF CHOLEllA. 41 

we beard of sickness and death ; some had lost two-thh'ds — hardly 
any less than half — their children. The houses were partitioned 
off into lodging-roomSj at rents averaging 2^. 6d. a week. In one 
case they had but an intermittent supply of water, at the bottom 
of the house, which, in some cases, was kept in water tanks of 
decaying wood. Some of these houses were close to slaughter- 
houses, where I saw the steam reeking up from the hot carcases ; 
some over cesspools, cleaned out, — some once in five, some once in 
seventeen years ; the walls were filthy ; the smells were either 
abominable, or exchanged for a closeness still more oppressive ; 
the passages dark and tortuous. And yet here were living the 
most respectable of the labouring classes, porters, policemen, and 
such like, who, though earning high wages, are pauperized by the 
sickness brought on them by these dwellings." 

In the district of Bethnal-green, where Cholera raged to a 
fearful extent, the homes of the poor are of the most wretched 
description. In some cases " summer-houses," in the gardens of 
the weavers, have been converted into dwellings, which afford but 
a partial protection from the weather. They are placed on the 
undrained soil; the privies are holes dug in the ground; the 
supply of water is derived from wells, polluted by the interniLxture 
of the slops and manure of the houses. Dr. Hector Gavin, in 
his " Sanitary Ramblings," describes District No. 4, of Bethnal- 
green, as " the hot-bed of epidemics." He says that as many as 
thirty persons reside in a single house ; and that in half a square 
mile 30,000 persons are congregated. The houses are generally 
of the worst description, and four-roomed. Those built by the 
French refugees are several stories high, and have large rooms on 
each floor, with a common staircase. Each room contains a family. 
The atmosphere is most oppressive, for it is a common practice to 
retain the faecal matter in the rooms, in order to avoid the filth of 
the ordinary privies and the exposure of going to them. It had 
been observed for many years before the first advent of the Cholera, 
that the poor were especially obnoxious to disease ; and members 
of the medical profession have again and again stated that much of 
the physical suffering of the poor was produced by the w'retched 
habitations they were compelled from their limited means to occupy. 

The "behaviour" of the Cholera in 1831 further opened the 
eyes of the profession and the public. The strongholds of typhus 



42 THE DWELLINGS OF THE POOR 

became the impregnable fortresses of the Asiatic pestilence. In 
the crowded comis and alleys of om* cities it slew its thousands, 
and from those spots it occasionally launched its arrows into the 
broad thoroughfare, and struck down more wealthy victims. 
Science, though her hands were bound, had yet her eyes open ; 
and while she lamented the weakness of curative medicine, she 
rejoiced in the hope that preventive measures might eventually 
succeed in annihilating or arresting this most appalling epidemic. 
To this circumstance we must attribute the rise and progress of 
the agitation for sanitary reform. Men in high places have been 
taught, that a disregard of the physical welfare of the poor en- 
dangers not only the health of the rich but the stability of the 
whole commonwealth. 

The dwellings of the labouring population, both in our cities 
and villages, are either built without any regard to hygienic rules, 
or are rendered unhealthy by the number of persons compelled 
from poverty to congregate within those dwellings ; — 

•* magnis opibus dormitur in urbe ; 



Inde caput morbi," 

says the Roman satirist, and he enunciates a fact applicable to 
our own times. Even supposing the houses of the poor to be 
well built and well drained, they become unhealthy from being 
crammed with human beings, and from the domestic operations 
which in them are necessarily carried on. There is scarcely a day 
in which soiled linen is not washed by one or more of the families 
in the house; and lines are extended along the passages, up the 
stairs, and in the rooms for the purpose of drying it. There is a 
daily scrubbing or wetting of the floors ; and nearly in every room 
there is a bedstead, which is either turned up during the day, or 
occupies a large portion of the apartment. In either case the 
blankets and linen come but little in contact with fresh air. At 
night every room is closed, and the inmates are thus compelled 
to breathe an atmosphere surcharged with noxious exhalations. 
That such "homes" are productive of Cholera the following 
facts, of which we have personal knowledge, will abundantly 
prove. 

In one of the small streets in the west end, we once visited, with 
a medical friend, a child which had l^een suffering many months 



A SOURCE OF CHOLERA. 43 

from cliarrlicea. The father was a brickinaker, and could earn 
during the summer about £S weekly. For the sake of economy 
and convenience^ himself and family (seven in number) occupied 
the front kitchen, — a room about fourteen feet square and rather 
more than six feet high : the ceiling being but just above the 
level of the street, a very limited amount of daylight could be 
admitted through a small window, defended with iron bars on the 
outside. The family were at dinner when we arrived. In a dark 
corner of the room was a stump bedstead, in which we found the 
mother, recently confined, and the sick child ; and, from the 
peculiar circumstances of both, and with only the occasional 
attendance of one of the lodgers as nurse, the personal and the 
bed linen were not in that cleanly state generally considered ne- 
cessary to health. In another part of the room sat the husband 
and a young man at dinner. A line was extended across the room, 
upon which were hung some articles to dry ; and by the fireplace 
stood a wash-tub, from which they had just been taken. The 
description of this room will serve for all the apartments in the 
house ; nay, for all in the street — in which, later. Cholera raged 
with the greatest virulence. 

The report of the ravages of Cholera in the eastern and 
southern districts of the metropolis had not long reached the 
fashionable districts of Belgravia before the attention of the in- 
habitants was attracted to its obscure streets. With an eccen- 
tricity for which Cholera is remarkable, it visited a particularly 
poor locality, swept off its victims, and then passed on to another 
— till at length it reached the street in which our youthful 
patient lived, and the first victim was its father. In seven hours 
he succumbed. The pestilence once commenced, it ran like wild- 
fire through the street — not, however, invading every house, but 
only the most wretched. 

The next victim was a sister of the man to whom we have 
just referred. The house in which she lived was a hovel of the 
humblest description. It consisted of two rooms, one on the 
ground-floor, another above, with a " lean-to '^ at the back, — 
which served as a dormitory for the children, seven or eight in 
number. The woman died of consecutive fever, after seven days^ 
illness. The house was entered by a narrow passage, the floor of 
which was rotten and broken in various places. The room in which 



44 THE DWELLINGS OF THE POOR 

the woman died was about seven feet wide^ and ten or twelve 
feet long ; and at night, during her illness, the floor was the 
sleeping-place of several human beings. For seven days the 
corpse was kept in this apartment, — the family, and one or two 
sisters, sleeping together on the floor, in the presence of the dead. 
Three doors distant from this house a poor man was attacked. 
The room in which he dwelt was hardly large enough to 
hold his bed. In four hours his sufferings were terminated 
by death. On the opposite side of the way, a man living in 
the front-room of the first-floor was attacked. He had expe- 
rienced no premonitory symptoms, but went to bed in his usual 
health. At midnight the Cholera seized him, and at four a.m. 
he sent for medical assistance. The surgeon on entering the 
house was struck with a peculiar " earthy " smell in the passage. 
It arose from a damp and unwholesome cellar beneath. In eight 
hours the patient died. He had resolved to leave the house in 
consequence of the " bad smell " in the morning before the doors 
were opened, but he deferred his purpose till death summoned him 
to the grave. Five months previously, the Local Board of Health 
had ordered the privy to be emptied, and a drain to be constructed 
into the sewer. It was done; but the tenant of the house, to 
avoid expense, had a shallow trench dug in the garden, into 
which the soil was emptied, and covered over wdth two or three 
inches of earth. The wife of a man living next door, but the 
window of whose apartment opened into this garden, was attacked 
with Cholera. 

Facing this street were two cottages in ^\^hich five cases of 
Cholera occurred, one proving fatal. The smell was so intolerable 
in the morning, before the houses were opened, that lodgers 
rushedj with suspended breath, to the front or back-door to 
open it, and breathe the external air. In one of the back- 
kitchens was a cesspool, six feet deep and three feet wide, filled 
with soil. In the yards were three cesspools, which were sub- 
sequently emptied by order of the local Board of Health. In 
some of these houses the drains were so badly constructed that the 
more liquid parts of soil escaped frequently into the surrounding 
earth, producing a stench in the houses almost intolerable to the 
inhabitants. 

The published official documents of the Government incontestibly 



A SOURCE OF CHOLEKA. 45 

prove, tliat the houses of the poor are fertile sources of disease ; 
and it is to be hoped that some legislative enactment will ere long- 
render them more conducive to health and comfort. It is not in 
London only that the labourer and his family are compelled to 
occupy tenements which demoralize and destroy them. In what- 
ever cities or towns Cholera, or any other fatal epidemic, has pre- 
vailed, there we find the artizan badly lodged. In Liverpool, 
INIanchester, Edinburgh, Bristol, and Gloucester, the fact is 
palpable ; and we have before us a Report of the Sanitary 
Condition of Sheffield, in which Cholera, fever, and consump- 
tion, are attributed, in not a few instances, to the neglected 
condition of the dwellings of the poor. One extract only we shall 
make : — " Peacroft is exceedingly close, the rooms of the houses 
low, dark, and ill ventilated ; a privy here, which is perfectly full, 
is exceedingly offensive, and the house-drains are bad. Eighteen 
persons were all recently afflicted with fever in this yard at the 
same time; and on two occasions, during the last fifty years, 
every inhabitant suffered from the same disease. One tenant has 
lost the whole of her children, nine in number, during her resi- 
dence here. A privy, in the lower part of Cupola-street, has been 
placed with so little consideration for the health or comfort of 
those near it, that it drains freely into the adjoining house, and 
evaporates into the chamber above ; and altogether is so pernicioxis, 
that the late tenants, both husband and wife, died from its effects. 
In Court 3, Edward-street, fever is prevalent among the children. 
Ten out of a family of fourteen children have died in the house 
nearest the privy ; the Asiatic Cholera was also very bad in this 
yard, and other cases of death occurred.^^ 

It is vain, under such circumstances, to expect our labouring 
population to enjoy a high degree of health, or to exhibit an ele- 
vated morality. They have been degraded and pauperized to a 
large extent by their superiors in society, who ought to have exhi- 
bited a greater regard for their social comforts. A paternal 
Government will respect the just demands of medical science and 
the claims of humanity. 

Will the reader bear with us yet a while, and accompany us 
to a few of the scenes we have lately visited ? In the early part 
of last November a poor boy, of ten years old, suffering from 
fever, came under our observation. He was miserably emaciated 



46 THE DWELLINGS OF THE POOR 

by want and by disease, and evidently in a hopeless state. 
Hearing that his brother had died from the same cause, and that 
his mother and sister where then lying ill, we determined to visit 
their home. 

It was the 9th of November when we found a spare hour to visit 
the wretched room he called his home. Poor lad ! the Angel of 
Death had by that time borne him to that world "where the 
wicked cease from troubling, and the weary are at rest.^^ 

From a court-yard leading out of one of the city thoroughfares 
we entered the abode of the mother. The room, about eight feet 
by ten, smelt close and offensive. A hard-featured woman sat in 
a chair watching the last hours of the unhappy woman — a pauper 
nurse by a dying pauper. The mother herself lay on a heap of 
clothes, dignified by the title of a bed. The couch thus formed 
occupied the whole of one end of the room. Emaciated to the 
last degree, her hectic cheek, sunken, yet still bright, eye, livid 
lips, panting breath, short hacking cough, conjoined with a 
deadly cavernous gurgling beneath her clavicles, told her present 
condition, — told that ere many days, she too would be numbered 
among those who had been. While surveying the wretched home, 
the tiny coffin of a child, perhaps some three years old, caught 
our eye. It was that of the sister. The detail of her case we 
gathered ; and no doubt she, like her two brothers, had been cut 
off prematurely by " the fever," as the people emphatically 
termed it. The mother's tale was one of the short but touching 
''annals of the poor." Her husband had died some two 
years before; she had parted with the greater portion of her 
worldly goods; had worked hard night and day, and occupied 
this little room with her three children. Her second boy sickened 
of fever and died. He was delirious ; she sat up the night with 
him. He wanted nourishment, so she worked during the day for 
him. She fell ill herself — what matter ! she could still crawl about. 
The little girl fell sick of "the fever" and "was like to die," she 
said, " so I could not lie by. Jemmy then sickened, and they 
sent him to the hospital. I could get about no longer. I shall 
not trouble them long." — It was true. Foul air and pestiferous 
vapours, added to fatigue and want, had induced phthisis; and 
when no longer able even to help herself, much less to aid the 
dying infant, she procured a nurse from the workhouse. 



A SOURCE OF CHOLERA. 47 

We passed from this abode of deaths where lay a mother and 
her three children struck down by disease which Avould never 
have visited them but for the want of due sanitary regulations. 
We thoug'ht as we passed Guildhall, then decorated for the feast, 
that surely the blessings of the poor would have been more grate- 
ful to the city authorities than the odour of the banquet ! 

There are many courts leading from the south bank of the 
Thames, the ventilation of which is effected by odoriferous gusts 
that ever and anon sweep up their narrow chink, laden at low 
water with stenches which the frequenters of those districts know 
too well. In one of these narrow courts (from houses opposite 
to each other neighbours might have shaken hands) in the front 
room on the ground-floor, lay, in the last spring, on a bundle of 
dirty linen, a man some thirty years of age, whose yet shrunken 
fingers, and other signs not here to be detailed, evidenced pretty 
clearly the truth of his own tale, that he was but then recovering 
from an attack of Cholera. The room was small and dark ; there 
were no drains to the house ; two grim men, and as many hag- 
gard women, occupied the same room, but a stench filled the 
apartment too detestable to have proceeded from any of these 
li\dng beings. A grimmer object tarried there ; in the far side, 
on tressels, was a shell — on removing the lid we exposed a corpse. 
The parish and the poor were not agreed as to who should bury 
the dead, — and the half-putrid mass lay there, to difixise death 
among the living. 

You who can scarce bear to gaze on the dead 

" Before decay's effacing fingers 
Have swept the lines where beauty lingers," 

and even shudder at the sight of a corpse, while yet it may be 
said 

" He look'd so grand when he was dead," 

picture to yourselves this dark and dismal hole — the abode of the 
cholera-stricken, — the resting-place for days of the cholera dead, 
— the eating, drinking, sleeping home of several yet not cholera- 
stricken wretches ; — then rest in peace, or sigh over their con- 
dition, but make no efibrt to relieve it, if you can ! 

Last August four persons suffering from fever, from as many 
houses situated \\ithin a door or two of each other, entered one of 



48 THE DWELLINGS OF THE POOR 

the metropolitan hospitals. These houses were part of a court in 
St. Pancras. Certain that some local cause must have either 
excited fever in these four people, or have promoted the spread of 
infection, we visited their homes ; and the following are the con- 
ditions revealed : — These four houses formed part of seventeen 
which constituted a blind alley, open at one extremity only. A 
large square dust-hole occupied the centre. The houses consisted 
of two rooms, each on the ground-floor. The back-doors opened 
directly on the privies : the odour was most horrible. We felt 
sickened even with breathing it for a few minutes. The rooms 
were nine feet square, one small v\'indow in each. The sewage 
most defective. 

Under the floor of one of the two rooms of either house, 
passed a drain, or rather it appeared probable a cesspool occupied 
that situation. Whichever it was, one of the wretched inhabit- 
ants of the room told us, that not many weeks before the filth 
had burst the floor. '' I had but to tread,'^ she said, " on the 
boards, to see the black mud well up between the crevices ; and 
even now," (and our own senses bore testimony to the probability 
of the truth of her words), she added, "I have sometimes to rise in 
the night, and strive from the open window to obtain a little fresh 
air.''^ Imagine, reader, the invigorating freshness of that breeze, 
when we tell you, that into the dust-bin opposite to her window, the 
whole filth of the cesspool had been emptied the week before we 
visited the court. The people begged hard that something might 
be done to better the condition of their homes. 

You who think these people are contented with their dwell- 
ings, because they are used to them, go among them, and listen 
to their pleadings for relief ! 

We will conclude this chapter with an extract from the Medical 
Times of November 17, 1849. In noticing Dr. Hector Ga^dn^s 
Sanitary Rambles, we wrote as follows : — 

In the middle of August, 1849, Mr. Murray, the registrar for 
the Hackney-road district of Bethnal-green, made the following 
Report to the Registrar-General : 

" The 12th, 13th, and 14th of August will long be remembered 
m this neighbourhood; the hurried passing and re-passing of 
messengers, and the wailing of relatives, filled the streets with 
confusion and woe, and impressed on all a deep sense of an awful 



A SOURCE OF CHOLERA. 49 

calamity. The deaths chiefly happened in a space of about 400 
yards by 150. 

This space includes the Nichol-streets^ Half, Old, and New, 
NichoFs row. Tvirville-street, and the courts, &c., connected with 
them. With very great interest did we turn to Dr. Gavin^s 
account of particular streets, to see in what sanitary condition 
these death-struck spots were when he visited them in his ramb- 
lings. The Cholera had not then broken out. His mind could 
have been biassed by no prejudices. The following is the account 
he gives of Half Nichol-street : — '' On the surface of this street 
were bountifully strewn all kinds of dust, dirt, refuse, and gar- 
bage. It is not cleansed more than once in three weeks or a 
month ; and though cleansed (nominally) only last week, it was 
as filthy and dirty as if apparently it had not been cleansed for 
months. The inhabitants, in order to get rid of their refuse, 
solid as well as fluid, are compelled to throw it on the streets, 
there to putrefy and be mixed up with the mud. In consequence 
of the free exposure of the animal and vegetable remains, in a 
pasty state, to the sun, the muddy compost becomes most off'en- 
sive to the smell, and a constant cause of disease and death to 
the inhabitants. Invariably, wherever such filthy streets are found, 
so likeiuise are fever and the other zymotic diseases. Loud com- 
plaints were made to me, that the only way of getting rid of the 
refuse was to throw it on the streets, as the dustmen would not 
take it away unless paid for so doing. The inhabitants of this 
street complained bitterly that ' the people in it never died a natural 
death, but were murdered by the fever.' In the back yard of 
No 21, in this street, the soakage from the neighbouring privies 
had permeated through the wall, infiltrated them, and spread itself 
over the yard, when the offensive soil was covered over, and, as it 
were, dammed up by collections of dust, cinders, and refuse. The 
poor-rate collector complained of this place as a great nuisance.^' 

In Nos. 6, 9, 12, 16, 21, and 22, of this street, eight deaths 
occurred during the 12th, 13th, and 14th of August. The same 
street of which the unfortunates who dwelt in it complained in 
1848, " that its inhabitants never died a natural death, but were 
murdered by the fever," was the same street which formed a scene 
of Mr. Murray's graphic sketch in 1849, 

The same house, the walls of the back yard of which Dr. 

E 



50 THE DWELLINGS OF THE POOR 

Ga\'in said in 1848, were infiltrated by night-soil from the neigh- 
bouring privies, and the yard itself spread over with the same, 
only dammed in and covered by cinders and refuse, — this same 
house. No. 21, was one of the earliest visited by Cholera in 
1849. 

Fever and Cholera, Cholera and fever, are the alternating 
visitors of these unhappy abodes. 

In NichoFs-row, Dr. Gavin says : 

" A cellar here serves for a dust-bin and a privy." 

Of Turville-street : 

" Eight houses are without any supply of water. One privy is com- 
mon to seven houses. They are all nasty, and horribly offensive." 

Of Shepherd^s-court : 

" Excessively dirty and foul. The privies are confined and dirty. Ex- 
crements are scattered abroad." 

The other streets above referred to appear to have been in a 
similar sanitary condition. 

During the progress of the Cholera, death, induced by that 
disease, entered two-thirds of the houses in Half Nichol-street; 
more than half the houses in Turville-street ; nearly half those 
in New Nichol-street ; and more than a third of those in Old 
Nichol-street. " The moral bearings of the question are," says 
Dr. Gavin, " too vast to enter on.^' 

Yet, with such facts as these before them, men proceed to the 
temple of an omniscient God, and, on bended knees, supphcate 
Him to remove the pestilence from among them, while they leave 
untouched those second causes, which their own intelligence. His 
gift. His voice, teaches them must inevitably re-produce the 
malady. Do they expect a miracle, that the contributions of the 
wealthy may be spared ? 

Now, as then, mankind need to apply the fable so admirably 
told by the enchanting and amiable La Fontaine, which we have 
ventured to " do " into English : 

"AIDE TOI, LE CIEL T'AIDERA." 

A wagon, piled high up with hay, 
Stuck in a muddy road one day : 
The driver raised to Heaven his eyes, 
And knowing that his anxious cries 
By mortal ears could not be heard, 
To Hercules his suit prefer'd. 



A SOURCE OF CHOLERA. 51 

" Oh, Hercules!" — lie trembling said— 

" Lend to a wretclied man thine aid ! 

If it be true that once thy back 

Sustain'd the world and did not crack, 

Place 'gainst my cart thy little finger, 

And in the mud we shall not linger." 

He ceased ; and, answering his prayer, 

A gentle whisper stir'd the air. 

*' Too soon," a voice spoke in the breeze, 

'^ Thou clainist the aid of Hercules : 

He wills that man shall do his best. 

And then he comes and does the rest. 

Look well about thee — see the cause 

Which stays thy wagon. Nature's laws 

Are simple in their working — feel 

What mud encumbers every wheel — 

Clear it away — now break that stone — 

Fill up that ugly rut. Hast done ?" 

" All I have done," the driver said. 

" Now," said the voice, " expect my aid. 

Take up the whip." " The whip I 've found, 

But, bless me ! now the wheels go round.- 

Hercules, thanks!" The voice replied — 

" Let this truth in thy heart abide : 

To those who help themselves 'tis given 

Alone to hope for hel^jfrom Heaven ! " 

In conclusion, if doubt yet lingers in the mind of any man as 
to the relation between defective sanitary regulations and the 
spread of epidemic diseases, we would urge him to make, from the 
Registrar-GeneraPs Weekly Returns, street lists of the mortality 
from Cholera in Bethnal-green, and then to compare those lists 
with Dr. Gavin's account of the particular streets in the same 
parish. We will answer, from experience, that he must rise from 
his task^ — what Dr. Gavin strives to make every man, — an ardent 
sanitary reformer, convinced that he has no child's play, but God's 
work to perform. 



CHAPTER V. 



Appearance of the Cholera in England — State of the metropolis and other cities — Sanitary 

measures. 

The countiy had scarcely recovered^ or rather was still suffering 
from influenza and catarrhal affections^ which had proved very 
fatalj when the tocsin of alarm was sounded that a heavier cala- 
mity — a more inexorable plague was approaching our domestic 
threshold. Alarmed by the recollection of its ravages in the 
year 1832, the inhabitants of the metropolis and different towns 
throughout the kingdom convened meetings to discuss what pre- 
cautionary or preventive measures it would be expedient to adopt, 
and what sanitary regulations could be devised for the protection 
of the public health. The movement was general, and the atten- 
tion of the Government at this crisis was necessarily awakened to 
the impending visitation. 

It becomes, then, a prime necessity, before entering upon the 
course of an epidemic, to notice particularly the conditions exist- 
ing at the time or before its outbreak, and to endeavour to ascer- 
tain in how far a connexion may be traced between them. To 
this we now proceed. 

In 1847, a Commission was appointed, by Writ of Privy-Seal, 
to inquire " whether any and what special means may be requisite 
for the improvement of the health of the metropolis, with refer- 
ence, more particularly, to the hovise, street, and land drainage, 
street-cleansing, and paving ; the collection and removal of soil 
and refuse, and the better supply of water for domestic use, for 
flushing sewers and drains, and cleansing streets; and also as to 



SANITARY CONDITION OF LONDON IN 1832. 53 

the best means of using existing works, and of erecting new works 
requisite, and of maintaining them in good action ; and also as to 
the most equitable provisions for regulating the charges, or assess- 
ing, collecting, and paying the monies requisite for such purposes, 
more especially in the districts chiefly inhabited by the poorer 
classes of the population." 

The Commission being duly appointed, derived its information 
from the most authentic and unexceptionable sources — examining 
men well known to have had great experience in the treatment of the 
disease, and who were well acquainted with the causes that aggravate 
its intensity J besides which, they obtained from the best informed 
local authorities an exact account of the physical condition of 
different districts of the city in respect to ventilation, cleanliness, 
the state of sewage, &e. From the evidence thus obtained, it 
was ascertained that when the Cholera broke out in 1832, the 
labouring population in East Smithfield, where the disease first 
appeared, was in a wretched condition. The streets were de- 
scribed to be neglected and polluted with stagnant pools of putrid 
water and decaying vegetable and animal matter. The houses 
were over-crowded, ill-ventilated, and in a filthy condition. From 
this hot-bed of pestilence the disease spread along the sides of the 
river Thames down to Limehouse, and across to Uotherhithe and 
Bermondsey. Here all the auxiliary causes which favour the 
development and extension of disease were in active operation ; 
added to which, the poorer classes were exposed to the depressing 
influences of poor diet, scanty clothing, exposure to the vicissi- 
tudes of the weather, and the fear naturally produced by hearing 
that death was busy in almost every house around them.* It 
was contended, and that on very good grounds, that the poorer 
classes of the people would cheerfully hail and assist the autho- 
rities in cariying out any measure that might meliorate their 
condition. Hence arose the question as to the policy of establish- 
ing Cholera hospitals, which, on account of concentrating and 
perhaps ginng intensity to the supposed contagious nature of the 
disease, was strenuously opposed. Hence, also, the proposition of 
adopting model lodging-houses, such as that in Glasshouse-yard, 
for the reception of inmates, who should be protected from the inva- 
sion of epidemic diseases generally by a proper system of ventila- 

* Evidence of Robert Bowie, Esq., Surgeon. 



54 SANITARY CONDITION 

tioiij cleanliness^ and pure water. It was^ indeed, shown that while 
fever in this district had raged to a great extent in Glasshouse- 
street, and its adjacent courts and alleys, the inhabitants of the 
Model Lodging-house had escaped being attacked. 

The only deaths that occurred among the lodgers were two 
children, labouring under hydrocephalus intcrnus when admitted, 
and an aged and mutilated seaman, who had long been suffering 
from hydrothorax and disease of the heart. 

In Southwark, and its densely populated neighbourhood, the 
majority of those who were attacked by the Cholera in 1832, were 
occupants of Kent-street, the Mint, and other courts and alleys in 
the parish. These persons are described to have been filthy in 
their habits, and from living in confined and impure air, were in a 
state of susceptibility to be affected by any miasma or contagious 
matter floating in the atmosphere ; there were many vagrants and 
mendicants who inhabited the low lodging-houses, where they 
slept for a penny or twopence per night, in a wretchedly destitute 
condition. Many of their habitations had not even cesspools ; the 
soil was oozing from the corners and through the pavement of the 
courts ; and where there were cesspools they were in very bad con- 
dition — seldom or ever emptied. The supply of water was also very 
deficient. The pavements of the courts and about the houses were 
nearly all broken up ; and, within these dens of pestilence, there 
was no boarding to the floors, and the inmates slept on the earth, 
or sometimes on a few shavings. In 1847 the condition of this 
district was a little improved, but not much ; in some courts, as in 
the Three Tuns-coxu't, in White-street, in which there are about 
fifteen houses, and probably 150 inhabitants, principally Irish, 
these evils were even augmented. Here there was but one privy, 
and that without covering — the fluid soil running down the court 
in front of all the houses. Here also they had no water but what 
they could beg from the neighbours. Several of the houses were 
entirely without windows, or boarding on the floors. The pro- 
prietor of the court was in prison for debt, and the people crowded 
there because they had to pay no rent. No person was responsi- 
ble for them, nor was there any law to enforce proper sanitary 
measures. The Court Lcet, the Commissioners, the Magistrates, 
and the Commissioners of the Borough Pavements were, it is true, 
applied to; but there Mas no law to compel them to put the place 



OF LONDON IN 1833 AND 1847. 55 

in a condition fitting for human habitation. Other courts, where 
the inhabitants paid rent, were in a condition ahiiost equally 
deplorable. " In such places, typhus, it was proved, had, at 
various periods, been very fatal ; and it was to be antici])ated that 
Cholera would assume a very malignant aspect in this locality 
should it again visit the country. In regard to drainage, supply 
of water, and ventilation, which so notoriously diminished the sus- 
ceptibility to epidemic diseases, no material improvement of any 
kind had taken place, and the district in 1847 remained in the 
same wretched state. The fault, however, rested not, be it ob- 
served, with the people. They had no means to procure water, and 
the little they could obtain was not got without very great labour. 
The women were obliged to carry it up stairs, and were, conse- 
quently, very sparing in the use of it ; and those stairs being 
common to all the families in the house, no one considering it her 
duty to clean them, were always in a filthy state. Even the water 
for drinking, and other domestic purposes, had an offensive odour, 
from having absorbed the foul air of the room; though, indeed, 
water for drinking, or even washing the hands, could seldom be 
procured. It was also very common to find the clothes which 
had been washed in filthy water hung up to dry in the room, — the 
evaporation from which must obviously have been most pernicious ; 
and in the room in which the air was thus poisoned, there were 
often two or three children ill in bed, or even a greater number, 
or perhaps the father or mother themselves smitten with typhus 
fever. In this district these miserable houses were badly drained; 
they had mostly cesspools, very few of which communicated with 
sewers ; but the most depressing influence upon the health arose 
from the number of open sewers which surrounded and intersected 
the district. These ditches and sewers were sluggish, and evolved 
noxious gases, and hence typhus fever was always prevalent in 
the vicinity."* 

In Rotherhithe, the same deplorable condition existed ; the 
houses were badly drained, badly supplied with water, and an 
open ditch received the contents of all the privies. Here there was 
a block of houses where the privies hung over the ditch, and the 
paths in the fronts of the houses were all unpaved and filthy. The 
district was excessively ill-drained and intersected with ditches and 

* Evidence of H. L. Hooper, Esq., Surgeon, London-roart, Soullnvark. 



56 SANITARY CONDITION 

stagnant water. Since the Cholera visited it in 1833, a few of the 
sewers had been arched over, and some new ones constructed. In 
some parts water also had been laid on ; but most of the dwellings 
were wretched hovels. Manj^ of the places in this district being 
below high-water mark, the houses were subject to inundations 
from these sewers wherever the Thames ovei*fl.owed. Hence the 
neighbourhood was always more or less unhealthy, and the medical 
practitioners found that for a considerable period after such inunda- 
tions, catarrhal and rheumatic affections prevailed to a great extent. 
In Lambeth matters were no better. Here the Cholera, in 18S2, 
principally prevailed in low marshy situations, in crowded^ ill-ven- 
tilated courts and alleys. The drainage in the streets, courts, and 
alleys where the disease was rife, was extremely bad ; the privies 
were veiy often in the cellars ; and stagnant pools of water, some- 
times two feet deep, were decomposing before the houses, to enter 
which the inmates were obliged to walk along planks, placed before 
the doorways. At the time of high tide, in Fore-street, the dwel- 
lings were blocked up with boards and plaistei', to prevent the 
water from getting into them. This wretched state was not 
amended in 1847; — even then cesspools were very general in the 
district, the soil from them frequently swimming about in the 
water. The houses were generally damp and dirty, and it was 
impossible for the inhabitants, under such circumstances, to keep 
them dry and clean. There were several courts and streets in 
Lambeth-walk, some from Vauxhall-gardens, and other places, 
where fever constantly prevailed, and in these localities Cholera 
chiefly raged. The condition of the district had been little im- 
proved since the last visitation of Cholera, although additional 
common-sewers had been made ; but in veiy few instances, indeed, 
had the houses been supplied with drains into them. Even large 
houses had no drains into the sewers, — nothing but cesspools; 
water-closets were very rare even in the better class of houses; 
while as to the streets, courts, and alleys, in which the poor live, 
they were unimproved, and, indeed, had become more crowded 
since 1832. In some respects, matters were even worse, for the 
quantity of decomposing animal and vegetable matter about them 
was greater. Additional sewers had certainly been made, but there 
still existed great numbers of courts and alleys in which there were 
no drains, and fever of a typhoid character existed in those places 



OF LONDON IN 1832 AND 1847. 57 

to a great extent. There might be more sewers it was true, but 
the supply of water was not increased in proportion to their 
enlargement, and the sewers, therefore, could only act as extended 
cesspools.* 

It was chiefly in the filthy dens in these close courts and alleys 
that Cholera raged in 1832; and these localities, it was further 
demonstrated, had, since then, been very little amended. In 
1847 theJiouses were not sufficiently supplied with water. Here 
and thei^ there was a plug in the middle of the street, from which 
the poor people carried water. The effluvia given off from gully 
grates was offensive, and the sanitary condition of the population 
generally was not, in the least degree, improved. f 

Proceeding from these districts to that of St. Giles^, Blooms- 
bury, we find that the localities in which typhus, influenza, and 
scarlet fever, assumed a putrid type, were in Buckeridge-street, 
Bainbridge-street, LawT.*ence-street, and Church-street, where not 
one of the houses had a sewer, or even a common drain. All had 
cellars inhabited, and every room occupied by difi'erent families. 
The filth and dirt before the doors was dreadful, and the stench 
overpowering. 

We now come to another and most important specias of 
evidence, viz., as to how the improvement of localities, by 
pulling down nests of old houses, and forming large main 
streets affect public health. In this densely inhabited district, all 
the houses, except Church-street, and part of Lawrence-street, 
were pulled down and replaced by New Oxford-street. Church- 
street remained in the same state of horrible filth, indeed rather 
worse, from overcrowding consequent upon removal of other streets ; 
still these alterations have unquestionably improved the general 
health of the neighbourhood, inasmuch as admission is now given 
to cuiTcnts of pui'e air from above j but so long as these localities 
remain ^^athout sewers, and the present sewers remain as they 
are, no sufficient or permanent improvement will have been 
effected. ^Mien the wind blows in certain directions, the stench is 
throMTi back through the privies and water-closets, and, the supply 
of water being limited, accumulations take place, particularly in 

* Evidence of F. Wagstaffe, Esq., Police District and Parochial Surgeon in Southwark, Ber- 
mondsey, and Lambeth. 

+ Evidence of T. R. Leadham, Esq., Surgeon to the Poor-la-\v Union of St. Olave's, South- 
■wark. 



58 SANITARY CONDITION 

the months of July and August^ beneath the kitchen^ which taint 
meat^ and infect the atmosphere. The private houses of tradesmen 
and shopkeepers in this district are very little better than those in 
Chui'ch- street. However, wholesome diet, clothing, and fuel, along 
with better ventilation, and more light, are improvements which 
have already caused typhus to assume a less malignant type, but 
more pulmonary diseases and scrofulous affections prevail; and 
the number of children vsdth deformed legs and spines is incredible. 
The general effect of the alterations which have been made in 
Bloomsbury amounts to this, that the population of the neigh- 
bourhood has been diminished by about five thousand individuals, 
and, consequently, this locality has been improved at the expense 
of other parts of London. The people thus turned adi-ift congre- 
gated in the little back-streets leading to Drmy-lane; some migrated 
to Saffi"on-hill ; some to St. Luke^s; some to T\Tiitechapel ; but 
more to St. Marylebone and St. Pancras than to other districts; 
hence these parishes, which before were bad enough, are now into- 
lerable, especially as there has been a large influx of Irish emi- 
grants, during the last two years, among them.* 

In the parish of Christchurch, and the neighbourhood of 
Broadwall, where there were open sewers, and at Brunswick-place, 
the Cholera, in 1832, was unusually severe; in one row of houses, 
within two yards of one of the sewers, in houses which were veiy 
miserable as regards size, ventilation, and means of cleanliness, the 
mortality was excessive, — as many as five died in one house, and 
that place still remained, in 1847, without amendment. Hence it 
was clearly proved, that when certain atmospheric conditions prevail, 
and typhus arises, it is always found to be very malignant in these 
districts, and the result extremely fatal. The people li^dng in this 
district are described to be sickly and miserable, the children poor 
and dwindling. The great defect of the district is described to 
have been, very obviously, the state of the sewers and the house 
drains. '■'' '\'\Taen we visit the houses of the lower classes," observed 
one of the witnesses before the Commission in these districts, " we 
are met, or, as the expression is, almost ' knocked down' by offen- 
sive smells. On inquiring, we find that there is some house-drain 
stopped up, some cesspool deranged, or the cellar flooded. The 
lower offices of the houses in the neighbourhood of Holland-street 

■* Evidence of William Simpson, Esq., Surgeon, Bloomsburj'- 



OP LONDON IN 1833 AND 1847. 59 

and the water-side are subject to periodical floodings, and that 
with very filthy water. In the district of St. Saviour's the cir- 
cumstances are such as to account for the mortality."* 

In the district of Bethnal Green^f it was shown that cleansing 
was exceedingly neglected^ and that caused^ in the first instance, 
by a great want of water, and by a deficiency of drainage. Down 
the Bethnal Green-road, which is tolerably flat, there was no 
sewer for a distance of three-quarters of a mile in extent, on either 
side. This want of sewage was represented to the Commis- 
sioners four years before; but the evil still remained. Hence 
many diseases abounded in this neighbourhood which would not 
have occurred had the places been properly drained — in fact, some 
few parts which had been rendered less humid, and where the filth 
had been carried ofi", had improved in health. Here, also, cess- 
pools were found to be very common, and frequently placed close 
to houses — nay, in some instances, under them. Moreover, it 
was added, that carrying water to the houses of the weavers and 
poor of Bethnal-green would not even be of much service to them, 
inasmuch as they have no means of getting rid of it when used. 
Owing to all this uncleanliness, and the impossibility of keeping 
the houses sufficiently ventilated and clean, there can be no question 
that the poorer classes are driven to public-houses, where they find 
themselves more comfortable. Hence we may discover a cause, 
also, of moral degradation, deeply afi'ecting the well-being of the 
poorer population. Here we may direct attention to the following- 
interesting Table, showing the number of persons sleeping in one 
room, its dimensions, and the times when death would take place, 
provided there were no ventilation. The document was drawn up, 
we may obsers^e, with great care and accuracy, by Mr. Taylor : — 
" Little Collingwood-street, Bethnal-green, is divided into two 
portions; one contains twenty houses; the other, twenty-two, a 
little smaller than the former. Four of the houses in the first 
division are wholly without water, and their inhabitants have 
to beg it of their neighbours, ivho, in sujyplying it, subject them- 
selves to a penalty of, I believe, 51.'' 

* Evidence of Edward Doubleday, Esq., Surgeon, St. Saviour's. 

t Bethnal Green.— No. 2 District. — Bounded on the eastern side by the Cambridge-road, 
upon the southern by Elizabetli-place, Collingwood-street, Wellington-street, North street 
West-street, part of Tent-street, up into Bethnal-green-road, Hart's lane, and on the northern 
side of the road, about on a line with Hart's-lane. 



60 



SANITARY CONDITION 



No. of Houses 


Height of 
Room. 


Length of 
Room. 


Breadth of 
Room. 


No. of Persons. 


Death 


produced 
in * 




ft. in. 


ft. in. 


ft. in. 




h. 


m. 


1 








8 


6 


47 


2 








6 


9 


2 


3 








4 


13 


34 


4 








2 


27 


7 


5 empty 








— 


— 


— 


6 








6 


9 


2 


7 








5 


10 


51 


8 








6 


9 


2 


9 








2 


27 


7 


— 








7 


7 


45 


11 


\7 9 


9 11 


9 5. 


3 
6 


18 
9 


5 
2 


13 






5 


10 


51 


14 








6 


9 


2 


15 








2 


27 


7 


16 








6 


9 


2 


17 








4 


13 


34 


18 








2 


27 


7 


19 








7 


7 


45 


20 








5 


10 


51 


21 














22 






^ 









All tlie evils we have now enumerated were^ in Westminster, 
St. Giles^, Lambeth, and other districts, greatly aggravated by a 
new element of mischief; viz., the influx of Irish emigrants into 
neighbourhoods already overburdened with their own poor. The 
indolent, careless, and filthy habits of this lower order of Irish 
were quite sufficient to produce fever, whatever may have been 
their previous condition, they having no notion of ventilation, no 
care for personal cleanliness, never thinking of water, nor caring 
what they lie down upon — huddling together night after night. 
The lower parts of Westminster, already densely crowded, now 
became much more so, by the people driven in from St. Giles', 
and the other neighbourhoods where the old houses had been 
pulled down to make clearances for the improvements. In such 
neighbourhoods as these, it is very evident Cholera was to be 
expected in its most aggravated and malignant form. 

Among some supplementary evidence which was laid before the 

* Evidence of Thomas Tayler, Esq., Surgeon, Bethnal-green. In calculating this column, 
the following data have been used ; namely, — that each respiration is 40 cubic inches (Menzies), 
the respirations 20 per minute (Haller), and that the existence of -QSths of carbonic acid gas is 
destructive (Liebig.) 



OF LONDON IN 1832 AND 1847. 61 

Commission, the remarkable fact was shown, that Birmingham 
enjoyed an immunity from the Cholera, whilst Bilston, only ten 
miles distant, was ravaged by it. This was principally accounted 
for by the natural drainage of Birmingham being very good, 
owing to the elevation of the town (-150 feet, or thereabouts, above 
the level of the sea) ; and having therefore, it may be said, a 
better drainage than towns generally. 

The state of Westminster was particularly deplorable. Here 
both drains and sewers were very badly regulated in almost all the 
streets, particularly in Crown-street, Charles-street, Gardener^s- 
lane, and Princes-street. The noxious effluvia arising from these 
streets are of so pernicious a character, that some of the families 
who resided in Cannon-row during four or five years, were 
scarcely ever free from the deleterious effects of a tainted atmo- 
sphere. Adults and children alike were constantly suffering from 
typhoid affections, sore throats, or low fevers, until they removed 
to healthier places. In these localities it was predicted that 
Cholera would rage, and become malignant. Indeed, these situa- 
tions were seldom or ever free from scarlet fever, small-pox, and 
measles, which frequently assumed a typhoid character.* 

The concurrent testimony of all the medical men who prac- 
tised in these districts being thus far conclusive, it next becomes 
a matter of interest, in tracing the History of the Cholera, to 
ascertain how far the appointed public authorities discharged their 
duties, in endeavouring to improve the sanitary condition of the 
metropolis. It was one of the objects of the Metropolitan Com- 
mission to ascertain the extent to which the sewage might be 
improved : the authorities who were officially and scientifically 
acquainted with the subject, in all its details, were duly examined. 
Of their evidence we shall give the following brief abstract, retain- 
ing, as far as we can, the ipsissima verba of the several witnesses. 

Mr. Hertslet, the chief clerk to the Court of Sewers for West- 
minster and part of Middlesex, on being asked as to the extent of 
the works for the houses, streets, and main drainage which remained 
uncompleted in his district, and as to whether any plans were 
in existence on which he could rely for making an accurate return 
of the number of streets within the district which had sewers in 
them, replied : " We have such plans, but our new surveyor in- 

* Evidence of N. M'Cann, Esq., Surgeon, Parliament street. 



62 SANITARY CONDITION 

forms me constantly of inaccuracies in them. We have not a 
complete section of more than one or two of our main lines of 
sewers, while we have about twenty in our active jurisdiction. 
There must be: hundreds of courts and mews of which we have 
no plans and sections." His evidence then proceeded to show 
that what sections and scales they did possess had been made 
generally without reference to any fixed datum-line, and, as a con- 
sequence of this, they could not proceed with their works with any 
certainty. Speaking of the complaints made by tenants of insuffi- 
cient drainage, he observed that the greater part of the complaints 
received on the subject did not come from the poorer districts, as 
the poor were used to the want of drainage ; and never having, 
until recently, heard of the possibility of its being improved they 
bore their lot most patiently, and seldom made any serious 
grievance respecting it, — except, perhaps, that they objected to the 
collection of the rates. The complainants were, for the most part, 
of another class : — residents in Bryanstone-square, Montague- 
square, Norfolk-street, Park-lane, Upper Brook-street, and others 
in some of the principal main streets. Mr. Hertslet next attested 
as to the inconvenience and positive damage sufi'ered by the public 
by the division of districts for paving and sewage pm'poses, having 
the effect of creating various bodies, and separating the paving 
and cleansing of the streets from the works of the sewers and 
other means of surface-draining ; besides which, the most frequent 
difficulties were found to arise from the petty jealousies of the 
officers acting under the different authorities, and sometimes even 
the disagreements between the boards themselves. It appeared 
that there were in St. Pancras alone, from fifteen to twent)^ paving 
boards, and nearly 1000 commissioners. One of these boards 
alone spent about 1000/. a year for management, exclusive of 
works. The consequent waste in every way, therefore, from want 
of consohdation, was, he felt assm-ed, enormous ; nay, he was 
convinced that in three or four months, the wretchedly-drained 
city of Westminster might be placed in such a state of forward- 
ness as not only vastly to improve the health of the population, 
but also permanently to increase the value of property. 

It was then proved that among the Commissioners of Sewers 
were men personally interested as architects, builders, agents, 
&c. ; that although there was a clause in the act prohibiting com- 



OF LONDON IN 1832 AND 1847. 63 

missionevs who were interested from voting under a heavy penalty, 
yet that the penal clause having been struck out by the Court of 
Sewers before the Act went before Parliament, some of the com- 
missioners had so voted in defiance of the clause. That there had 
been some of the members remaining and acting on the Commis- 
sion who had been insolvent traders and outlaws, and some on the 
Committee of Accounts who had also been bankrupts. That among 
a certain class of the commissioners, private rather than public 
interest appeared generally to be consulted ; — that very few of the 
commissioners ever met, and then only to put down their names 
as ha^dng attended ; — that on a question of a proposed im- 
provement in the form of sewers, out of 140 commissioners who 
were summoned, only 31 voted ; — that on " dinner days " the 
attendance was more numerous and continuous, and of quite a 
differ-ent complexion ; — that the pertinacious resistance offered by 
a certain class of architects to recent improvements, and the extra- 
ordinary objections taken by some of them, were convincing proofs 
that drainage w^as a subject to which they had not attended; — that 
surveyor's reports, when they interfered with the private interests 
of a particular commissioner were repeatedly altered, to the detri- 
ment of the public. In addition to all these flagrant abuses, it 
was ehcited that the chairman was in the habit of altering the 
surveyor's reports. " But did not the officer remonstrate ? " 
the witness was further asked; and he replied, "He had been accus- 
tomed to it for so many years, that he thought nothing of it ; but 
the impropriety of his recommending what he did not approve being 
pointed out to him, he at length summoned up resolution to omit 
sending his report to the chairman.'' As the result of this course, 
the chairman obtained an order at the next court, that both the 
clerk and surveyor should submit all reports to him in future. 

These facts need no comment ; the following however deserves 
attention : — A short time since, it was found that a large district 
had been described on the plans as being in one division, whereas, 
it was really in another, and had of course been rated accordingly. 
When this was clearly ascertained, the officer who had laid down 
the line of demarcation admitted that he knew it was so, but a 
late chairman had so ordered it. " Then," said Mr. liertslet, 
" you have for many yea'rs, and on oath, misled the presentment 
juries." He replied, "Yes, but there ivas an order of court for it." 



64 SANITARY CONDITION 

Upon inquiry being made what improvements had taken place 
in the sewage since the occurrence of Cholera in 1832, it 
appeared that some two or three lines of sewers had been built, 
but very few houses were connected with them ; nay, the old 
drains were as bad as ever, and the system of pumping the sullage 
water into the gutters still continued, especially around Bucking- 
ham Palace. Many of the inhabitants in Dartmouth -street, 
Westminster, and near Buckingham Palace, were in the habit of 
pumping out their sewage water at night into the streets. Nay, 
the public are scarcely aware of the fact, that many of the very 
best portions of the West End are literally honeycombed with 
cesspools. Many houses have from three to six or seven under 
them. According to the statement of the Hon. Frederick Byng, 
there are constantly 2,500,000 cubic feet of decomposing refuse 
retained in the sewers and drains. There is scarcely any 
difference between the noxious effects of such sewers and cess- 
pools ; indeed, the exposed sm^face of the latter being greater, the 
annoyance is complete. 

Mr. J. Phillips, C.E., Chief Surveyor to the Westminster Court 
of Sewers, corroborated the previous witness on many of the 
above points, and added other instances of mismanagement and 
abuse as reprehensible. His evidence, indeed, exhibits the perti- 
nacious objections of the Commissioners of Sewers to the improve- 
ments which were suggested, whenever such improvements would 
lower the price to the public, although they might tend to secure 
gi'eater efficiency. He stated : " It had previously been a matter 
of routine for years, that the clerks of the works should inspect 
the whole of the sewers monthly, in their respective districts, and 
report accordingly. I had followed the usual course for several 
months, but as I proceeded with my inspections of the sewers, I 
began to perceive that I was signing my name to a deliberate 
falsehood." On this account, Mr. Phillips, on the 3rd of October, 
1845, wrote the following : — 

" Sewers Office for Westminsfer, Sfc, 
" A^o. 1, Greek-street, Soho-square, 3rd October, 1845. 
" In obedience to the order of Court (as expressed in bye law No, 60), 
namely, ' that each clerk of the works do endeavour to obtain every inform- 
ation on the state of the sewers within the district placed under his super- 
intendence,' and ' that in the course of every month he inspect the whole 
of his district and report his having so done, together with his remarks and 



OF LONDON IN 1832 AND 1847. 



65 



observations in the Book of Informations, in addition to such entries as have 
been usually made therein ; ' therefore I beg most respectfully to state that 
there are avast number of sewers under my superintendence that are similar 
to elongated cesspools ; that is, they retain neai-ly all the sewage jnatter that 
is discharged into them, instead of affording efficient means for speedily 
carrying it off; and the stench and effluvia evolved from the decomposing 
filth thus accumulated escape through the untrapped gullies and drains, and 
contaminate the surrounding atmosphere with their nauseous and deleterious 
gases, to the great injury of the health of the public ; consequently they 
should not only be cleansed forthwith, but some ready and effectual means 
should be adopted in order to prevent the matter discharged into them after- 
wards from becoming deposited upon their bottoms. 

*' (Signed) John Phillips, Clerk of the Works." 

Mr. Phillips then continues with the evidence before the Com- 
mission^ and remarks^ — 

" I asked the other clerks of the works to sign that report with me ; but 
they refused, though they did not, nor could they, deny the truth of what I 
had written. But I believe they abstained principally from fear. 

" Q. Fear ! of whom ? — /^. Of some of the most active of the Commis- 
sioners. 

" Q. Of some who are now Commissioners? — ^. Yes; particularly of one 
individual, from whom I then experienced, and have continued to expe- 
rience, much bitterness of feeling and opposition ever since I made that 
entry." 

The condition of the sewage in about one hundred and thirty- 
streets which the witness examined will be seen by the following 
cuts, exhibiting as a dark mass, the accumulations which were 
choking up the sewers, thus preventing drainage and elimina- 
ting noxious vapours ; 





66 



SANITARY CONDITION 





The remaining evidence of this witness bears chiefly on scien- 
tific details_, at the same time that it clearly proves how much 
expenditure in public works may be economised without detriment 
to the public interest. On this point an instance is given where 
an immense sewer had been constructed without the least advan- 
tage to the neighbouring buildings. The following shows the 
size of the sewer and the condition in which it was found ; giving 
an instance of the effect of a run of water in a small sewer^ and 
of the common operation of a large sewer without a constant and 
a sufficient supply of water. The woodcut represents a sewer 
constructed in Langley- court, Long-acre, with the obstruction at 
the outlet of the smaller sewer : 




Mr. Phillips was then asked, according to his experience, what 



OF LONDON IN 1832 AND 1847. 67 

form or size would be sufficient for the drainage of the above 
court ? The following sketch represents that which he would 
have recommended as sufficient for all useful purposes : 



Captain Bague, R.N,, as Chairman of the Westminster Court 
of Sewers, having had his attention called to the evidence^ a sum- 
mary of which is given above, stated to the Commission : " I am 
quite aware that the evidence which Mr. Phillips and our clerk 
have given may cause pain to some of the Commissioners, but, as 
I observed before, I think both the clerk and the surveyor have 
given their evidence in such a straightforward way that there can 
be only one opinion upon the subject of it, namely, that it will be 
for the public good, and for the benefit of the public service.^^ 

We must, before bringing this part of our subject to a conclu- 
sion, refer also to the examination of Mr. G. Wilson, Secretary of 
the Board of Health for the parish of St. Margaret and St. John, 
Westminster, at the time of the Cholera in 1833. He also had 
visited the district, and being asked how far he considered the 
condition of the labouring population altered or improved in 
respect to drainage and sewage-water, replied: "With respect to 
the greater proportion of the parish, I believe it is exactly as it 
was ; from Palace- street, down York-street and Tothill-street, 
mth the streets branching out right and left therefrom, there was 
and there is, nothing but a surface drainage. The basements of 
the houses lie several feet below that surface drainage, and in order 
to get rid of the offensive liquids, the inhabitants of the houses 
pump it from the basements into the streets. In many cases, the 
pumps draw up the matter from the cesspools into the street, and 
there it lies until the godsend of a shower clears it away. We 
feel for the people, because they cannot inhabit the basement floors, 
unless they do this. And this is the condition of a street close 
to the palace, among the occupants of a property which belongs 
to the Crown.''^ Being asked what was the condition of the wells 
in Westminster, he says : " Really it would be well not to think 
about that, or we should deteriorate the proper txj of the district !" 

We shall next proceed — upon the principle of adhering strictly 

F 2 



68 SANITARY CONDITION OF LONDON. 

to the facts elicited by these examinations — to the Report itself 
of the Sanitary Commission^ which presents us with a variety of 
details throwing considerable light on the history and the pro- 
gress of this disease : 

" We now beg leave to submit the summary of our conclusions in this our 
first report. 

" Having consulted in relation to the rise and spread of Cholera, the ex- 
perience obtained in the most severely-visited districts in the metropolis, and 
also the most authentic records of the experience in the principal towns in 
Great Britain and in Europe, we find, in relation to this disease : — that amidst 
the town populations the Cholera visits with more severity the same classes 
of persons and the same places, and is governed nearly by the same circum- 
stances as typhus. 

"Tliat it has been proved by experience that those circumstances are gene- 
rally removable by proper sanitary arrangements, and that typhus is, to a 
great extent, preventible ; and we have every reason to believe that the 
spread of Cholera is preventible by the like means, namely, by general and 
combined sanitary arrangements. 

"That these arrangements, instead of being incidental and collateral to 
other measures, are paramount, and principal, and effective, — not only 
against Cholera, but also against other epidemics. 

" That when Cholera first appeared in this country, the general belief was 
that the disease spreads principally, if not entirely, by communication of the 
infected with the healthy, and that, therefore, the main security of nations, 
cities, and individuals, consists in the isolation of the infected from the unin- 
fected, — a doctrine which naturally led to the enforcement of rigorous 
quarantine regulations; the establishment of military and police cordons; 
the excitement of panic ; and the neglect, and often the abandonment of the 
sick, even by relations and friends. 

"That since opportunities have been obtained of a closer observation of the 
character of this disease, and of the mode in which it spreads through con- 
tinents, nations, cities, towns, and families, facts have been ascertained which 
are incompatible with the foregoing view of its mode of dissemination, and of 
its prevention. 

"That the disease is not, as it was generally supposed to be, contagious; 
and that the practical application of that doctrine did no good, but was 
fraught with much evil. 

"That when it previously visited this countr}^ it was believed that the most 
powerful predisposition to this disease is induced by improper or deficient 
food, and that, for this reason, its chief victims are found among the poor; 
but it is now universally admitted that a far more powerful predisponent is 
the habitual respiration of an impure atmosphere ; that the highest degree of 
susceptibility is produced where both these conditions are combined ; that is, 
where people live irregularly, or, on unsuitable diet, and at the same time 
filthily." 



PARLIAMENTARY PROCEEDINGS. 69 

The attention of Parliament having thus been called to the 
urgent and immediate necessity of introducing some measure for 
the better preservation of the public health, on the 4th of August, 
1848, Lord Morpeth moved and obtained leave to bring in a Bill 
to renew and amend the Act 9 and 10 Vict., cap. 96, for the 
removal of nuisances, and prevention of contagious diseases ; and at 
the same time, Mr. Labouchere brought in a Bill to prevent con- 
tagious disorders among sheep and cattle. The " Public Health 
Bill " had previously passed through its preliminary stages in both 
Houses ; and having received several amendments in the House 
of Lords, came down to the Commons on the 7th of August, for 
the House to declare its assent, or otherwise, to their Lordships' 
amendments. The debate on this matter was characteristic ; and 
one could hardly suppose that a grave body of imperial legislators 
were considering a measure which was about to take an important 
place in a crisis so terrible as that of a ravaging pestilence. We 
subjoin a succinct and curious specimen of hygienic legislation : 

" Lord Morpeth moved that the House should consider in committee the 
Lords' amendments on the Public Health Bill, and the House immediately 
resolved itself into the proposed committee. Several of the amendments 
were agreed to, and some others dissented from ; and it was determined to 
ask a conference with the Lords on the points upon which the two Houses 
differed. 

"Lord Morpeth moved that clause 61, called the Smoke Clause, which had 
been introduced by the Lords, should be agreed to. The necessity for such a 
clause was generally admitted ; but, of course, reservations would be made 
in favour of particular trades, to which the machinery requisite for the pre- 
vention of smoke might not be applicable, 

" Mr. FoRSTER objected to the clause being adopted, as one which would 
lead to much inconvenience and injustice. 

" Mr. Bright had opposed every Smoke Bill that had been introduced to 
that House, and he thought this clause contained all the absurdities of all the 
former measures put together. It would only tend to turn into ridicule the 
legislation of that House, as it was quite impossible to work out any Smoke 
Bill; for example, the kind of smoke to be put down was ' opaque smoke,' and 
it was to be considered opaque when it was not transparent. But did not every 
body see that the opacity of smoke coming out of a chimney would, by this 
description of it, depend very much upon whether there was a black or white 
cloud behind it? By the clause, opaque smoke was only permitted during a 
certain time, which was allowed for putting on fires ; but this would be found 
utterly unworkable. Sometimes the smoke of ten or twelve smithies adjoin- 
ing each other were sent out by one common chimney. The fires of these 
smithies were renewed several times an hour, and how, then, was it possiiile 



70 PARLIAMENTARY PROCEEDINGS ON 

to enforce an Act in sucli cases? In point of fact, tlie clause was ridiculous ; 
and it would be impossible to carry it out. Parties producing smoke were to 
provide a ' well-approved plan ' for consuming it; but who was to decide what 
the well-approved plan was? In Lancashire, no three men were ever found to 
agree upon any effectual plan for preventing smoke. 

"The Attorney-General said, the question was certainly beset with diffi- 
culties, and he must admit that the clause contained inconsistencies which it 
would not be easy to reconcile : if his noble friend took his advice, he would 
not press the clause upon the House. 

" Mr. MacKinnon supported the clause. 

" Mr. Henry Drummond thought the honourable gentleman ought to weigh 
well the meaning of the word * nuisance ; ' for the question might be raised 
whether black smoke was prejudicial to health. The only justification for 
such a clause as this was, that smoke had an effect on the public health. 
That House, on legislating, ought always to be very chary of entering on 
scientific subjects; they ought not to forget the lesson their experience had 
read to them in the matter of the excise on malt. The more he had seen of 
this Bill, the more he was satisfied that there was a great deal of quackery 
and weak philosophy in such questions, and that this clause was manufac- 
tured by a quack; it ought not too hastily to be presumed, that what were 
called nuisances were necessarily injurious to health. All persons connected 
with butchers and knackers were known to be more free from disease than 
any other trades whatever ; and it was a fact, which was also well known, that 
every trade had a class of diseases peculiar to itself. 

" Mr. P. Howard did not think it jJossible to apply the clause to any manu- 
facturing town. 

" Lord Morpeth was aware his honourable friend (Mr. P. Howard) repre- 
sented the highest chimney in England. When he had been told on autho- 
rity, he could not fail to expect that this clause should not work, he hardly 
should think it worth while to incur the odium which, rightly or wrongly, 
seemed to attach to its adoption. He held himself perfectly free, and, per- 
haps, bound to be a party to the introduction or furtherance of a Bill having 
the abatement of that nuisance for its specific object. 

" Mr. EwART would remind the Hovise that, as appeared from the evidence 
of Mr. Faraday, even if the opaque smoke were destroyed, gases would 
remain, which would be highly injurious. 

" The Lords' amendment was then rejected. 

" On Clause 83, to which the Lords had added a proviso, ' that nothing 
herein contained shall prejudice or affect the right of interment in any family- 
vault or burying-ground.' 

" Mr. Healey thought if interment in churches and vaults was injurious 
to health, it ought to be prohibited altogether. 

" Lord Morpeth observed, that the proviso had no doubt been inserted 
from tenderness to family feelings. 

" Mr. Hume hoped the House would disagree to the amendment. 

" The Attorney-General was of opinion that the proviso was contrary 
to the principle of the Bill. 



THE PUBLIC HEALTH BILL. 71 

" Mr, MacKinnon hoped the noble Lord would allow the proviso to be 
struck out. 

" Colonel SiBTHORPE asked if they should deny families who had family 
vaults the right of using those vaults. Would the honourable member for 
Lymington like to give up his family vault? Those who did so might be 
buried in the highway. He could not, as the noble Lord seemed disposed to 
do, treat with indifference and contempt the noble family of Carlisle. This 
was only a specimen of the changes now going on ; and he should not be 
surprised some day or other to see a cad, a respectable man in his station, 
sitting cheek-by-jowl with the noble Lord on the Treasury bench. 

" Mr. MacKinnon would confess that at first sight it seemed hard to deprive 
people of their places of burial. But interments in towns were most prejudi- 
cial to public health ; and sooner than that any one should be injured by 
those noxious vapours which rose in churches from coffins even soldered up 
in lead, he would be buried in the highway instead of his family vault. 

"Colonel SiBTHORPE said, so also would he, supposing that any noxious 
vapours were likely to proceed from himself. — (Laughter.) The subject was 
too serious a one for a joke. He could not help telling his honourable friend, 
■with all respect, that his argument was most absurd and foolish. Why, he 
would ask, had he never thought of it before ? For himself, in the w^ords of 
Ruth, he would only say, ' Where my father lies there will I lie,' be the 
penalty what it might. 

" The amendment of the Lords to the clause was then negatived. 

" In the discussion. Lord Morpeth read extracts from the despatches of our 
consuls in various foreign ports, containing descriptions of the ravages made 
by the Cholera, and showing the steady approaches which it was making to 
this country. He was, therefore, most anxious that the Committee should 
assent to the various precautions which the House of Lords had recom- 
mended as best calculated to arrest the progress of that terrible disease." 

Again the Bill went up to the Lords^ and was finally disposed 
of as followSj on the 15th of August : 

" Lord Campbell, in moving the consideration of the Commons' amend- 
ments on those of the Lords to the Public Health Bill, expressed his dissent 
from most of them ; but, inasmuch as the alternative was to accept them or 
to throw out the Bill, for the sake of the public he asked their Lordships to 
agree to them. 

"The Earl of Ellenborough complained that their Lordships' amendments, 
to which the support of the Government had been promised, had been aban- 
doned by them. The tendency of all the amendments made by the Lords 
was to extend the influence and benefits of the Bill, to do so at the smallest 
cost, and to secure the proper appropriation of the money of the public to 
the object to which it was intended to be applied; but he believed by the 
Commons' amendments many places in the country would be altogether de- 
prived of the advantage of its adoption, while in every local board as the 
Bill stood there would be a power of jobbing which their Lordships' amendr 
ments would have prevented. The measure was not what it ought to be, nor 



VZ THE GENERAL BOARD OF HEALTH. 

what he hoped it would become ; but such as it was he would accept it rather 
than give the House of Commons an opportunity of rejecting it altogether. 

" The Marquess of Lansdowne expressed his deep regret that the Commons 
had rejected their Lordships' amendments, particularly those which gave a 
more efficient contrd over local boards ; he trusted, however, that the provi- 
sions of the measure would lead to the exposure of the jobbing system, and 
thereby prevent its repetition. 

" Lord Redesdale complained of the rejection of the Prevention of Smoke 
Clause, and thought the Bill ought to be sent back with it re-inserted, believ- 
ing if that were done the Commons would agree to it. 

" Lord PoRTMAN also regretted the loss of the clause, but thought it would 
be unwise to return the Bill with it re-inserted, which might have the effect of 
preventing its passing in the present session. 

" The Duke of Argyll having expressed a similar opinion, the Bill was 
read a third time and passed." 

By this Act (11 and 12 Vict.^ Cap. 63), a General Board 
of Health was provided, and sucli was constituted. The First 
Commissioner of Woods and Forests (Lord Morpeth) was the 
President, and Lord Ashley and Mr. Edwin Chadwick, the two 
other members; this Board having the superintendence of the 
execution of the Act, and the appointment of officers, inspectors, 
&c. On a petition from a certain number of inhabitants of a place 
or parish, the Board might send a superintending inspector to 
make a public inquiry (of which fourteen days' notice was to be 
given) to examine witnesses as to the sewage, drainage, supply 
of water, the state of the burial-grounds, and the number and 
sanitary condition of the inhabitants. The Act contained 154 
clauses of a sanitary character. 

The public, from various circumstances, now became alive to 
the necessity of not only setting their houses in order within, but 
of looking into the state of affairs without ; — such as the cleansing 
of streets, the supply of water, the state of the sewage, &c. In 
the latter respect, Messrs. "Walker, Cubitt, and Brunei (three 
eminent civil engineers), had been appointed to examine into the 
sewers of the City of London. These gentlemen made their 
Report at the latter end of August. Ha^dng considered the 
evidence given before the Sanitary Commission on this subject, it 
will be interesting, if only for the sake of comparison, to give the 
conclusion which these civil engineers came to on the state of the 
sewage. Their Report concludes with a short abstract of their 
general opinion in reference to the City sewers : 



engineer's report on city sewers. 73 

" We think," they state, " that although there may he exceptions in particular 
cases, the present sizes of sewers are not too great, and that they ought not 
to be lessened. 

"That the sewers, lohere made, are efficient. 

" That as from three to four miles only of the fifty miles of streets, courts, 
and alleys, within the City, are without sewers or drains, it is desirable that 
the same be constructed as soon as arrangements can be made for the pur- 
pose, so that every street, court, or alley, within the City, may be efficiently 
drained. 

" That the City sewers, which receive the sewage of the portions of the 
adjoining county, are sufficient for the discharge of the county and City 
drainage. 

"That as, of the 16,000 houses and buildings in the City, 6,672 have not 
private covered drains, it is desirable that these be provided. 

" That the fall or inclination in the private drains is generally such as to 
keep the drains clear of deposit. 

"That any general search for cesspools, for the purpose of opening and 
emptying them in private houses, would be impolitic as a general measure, 
and would be likely to be more injurious than the cesspools now are, if they 
are properly constructed, which should be ascertained. 

" That the form of sewers has practically very little to do with the general 
question of their keeping clear of deposit, this depending very much upon 
their fall and the quantity of water ; but that no fall or quantity of water is 
likely to be obtained in the City sewers sufficient to keep them clear of ob- 
structions without the occasional aid of men in the sewer to remove hard 
deposit. 

"That the most eminent men of their time have been consulted in, or have 
directed the execution of the City sewers, including Wren, Wyatt, Dance, and 
Rennie. 

" That we have discovered nothing in the construction of the works which 
can justify our charging the Commissioners with waste in respect of the size 
or construction of the sewers or otherwise, although the outlay during the 
last ten years must have been great, as during that time more new sewers 
have been made than during the previous 130 years. 

" That the system of flushing has been introduced lately with great advan- 
tage, and is already considerably extended. 

" That the desiderata, in order to perfect the sewage of the City, are 
the formation of the three to four miles of sawers, the extension of private 
drains, and the flushing system by gates and tanks, as described in our 
Report. 

"That neither of the new plans suggested by the Surveyor to the Metropo- 
litan Sewers Commissioners, nor that of their Consulting Engineer, is ap- 
plicable to the City sewers." 

It must be borne in mindj tbat the above relates to the 
City Sewers alone, and not to what we may call the great 



74 T'IRST CASE OF CHOLERA IN 1848. 

outworks of Londou, which are chiefly refen*ed to in the Parlia- 
mentary Commission of Inquiry. 

The debates in Parliament^ and the discussions which now arose, 
prepared the public mind^ in some measure^ for the invasion of the 
threatened malady ; and in the return of the Registrar-General for 
the week ending July 29, 1848, we have the first case of undoubted 
Asiatic Cholera recorded. It is there stated to have occurred in 
Belgravia (sub-district) to a female, aged fifty-four. The duration 
of the disease was fifty-eight hours. In a note appended to the 
register, Mr. Jorden, the registrar, states that " this was a distinct 
case of Asiatic Cholera, occurring in his own practice, of which he 
had seen much both at home and in the east. The patient was 
said to have sufifered from a severe attack, when it prevailed before, 
some sixteen years ago. She was of delicate health, and suffered 
from psoriasis inveterata.^ She was attacked suddenly in bed, at 
four o'clock in the morning, having the day before dined on half- 
boiled cabbage and some sort of dumpling.'' 

Such was the commencement of the epidemic in the metropolis 
in 1848, and no sooner was the sad intelligence that it had really 
appeared, made public, than every journal teemed with gratuitous 
moral and medical counsel. Among all the various remedies which 
were suggested, the medical profession did not lose sight of a 
fact which had become patent to all observers, viz., that the 
dissemination of Cholera, whatever might be its proximate cause, 
was in some measure dependent on circumstances which were to 
be modified by appropriate hygienic means. Hence, among the 
various contributions to the weekly and daily journals, we find 
recommended comfortable and nutritious animal food of the solid 
kind, warm clothing, an attention to regular hours, free ventila- 
tion and cleanliness, as well as limewashing the dwellings of the 
poor ; abstinence from spirituous liquors, from all fruit and raw 
vegetables, from salt fish and oysters, and from all excesses which 
disturb or debilitate the constitution. 

It was with much pain and with deep sympathy, that we day 
after day read of such recommendations as the above. Tracing 
the progress of the disease, it was obvious that the Destroyer had 
chiefly marked out his victims from among the lower classes; 

* A cutaneous affection consisting of patches of rough, amorphous scales, continuous or of 
indeterminate outline ; from \po>pa, the itch. 



ORDER IN COUNCIL. 75 

and in contemplation of the circumstances by which that portion 
of our fellow-creatures were surrounded, we naturally proposed to 
ourselves the question, ATTiere, and how, if good and wholesome 
food be necessary as the prophylactics to Cholera, are the poor 
to find it ? How are theij to shelter themselves from, or avert 
the arrows of death ? Such questions suggest necessarily many 
awful considerations which every political economist who is really 
a friend to humanity will do well to reflect upon. It will be 
observed, by the above narrative, that the disease had reached 
those very Institutions which had been devoted to the shelter of 
the peunyless and houseless ; while in the houses and the hovels 
of the " poor ^' of England its ravages were appalling. And has 
the history of past pestilences in this country, notvathstanding all 
this, conveyed to us no moral or practical lesson ? We fear not ; 
for it is demonstrable that, to the gross ignorance of hygienic 
laws, — the bad habits of the lower order of the people, — the 
exposure of the working classes to the inclemencies of the 
weather, to insuflicient clothing, bad lodging, inefficient venti- 
lation, and unwholesome food, much of this dreadful calamity 
is to be attributed; in illustration of which melancholy truth 
many distressing cases might here be described. 

On the 5th of September, Parliament was prorogued, when her 
Majesty, in the speech from the throne, announced having given 
her cordial assent to the measures which had in view the im- 
provement of the public health ; and expressed an earnest hope 
that a foundation had been laid for continual advance in this 
beneficial work. 

The following Order in Council, dated the 28th of September, 
was afterwards gazetted : 

" Whereas, by an Act passed in the last session of Parliament, intituled 
' An Act to renew and amend an Act of the tenth year of her present 
Majesty, for the more speedy removal of certain nuisances, and the pre- 
vention of contagious and epidemic diseases,' after reciting that it is expedient 
that, when any part of the United Kingdom shall appear to be threatened 
with or affected by any formidable epidemic, endemic, or contagious disease, 
measures of precaution should be taken with promptitude, according to the 
exigency of the case, it is enacted that, in Great Britain, the Lords and others 
of Her Majesty's Most Honourable Privy Council, may, by order or orders, 
to be by them from time to time made, direct that the provisions in the said 
Act contained for the prevention of epidemic, endemic, and contagious dis- 



7Q PLANS FOR IMPROVING SEWAGE. 

eases be put in force in Great Britain, or in parts thereof. And whereas 
the United Kingdom appears to be threatened with a formidable epidemic 
disease, in consequence of the progressive advance of such a disease to the 
western portion of the Continent of Europe, and a case has arisen for putting 
in force the provisions of the said Act: Now, therefore, it is hereby ordered 
by the Lords and others of Her Majesty's Most Honourable Privy Council, 
that the provisions contained in the said Act be put in force throughout 
the whole of Great Britain immediately, from and after the date of this order. 
And it is further ordered, that this order shall continue in force for six 
calendar months, from and after the date hereof." 

Plans for purifying the sewers of London were now laid before 
the City Sewers Commission^ and referred for consideration to a 
Committee. The first was from Mr. G. Elliot, of lO^, Chandos- 
street, Covent-gardeu, which we give in his own words, as follows : 
— " I propose, premising that the sewers are constructed on the 
best principle, regularly flushed, with proper receptacles for dis- 
charges, and all gully-holes, street and surface drainage, to be 
properly trapped, that chimneys be erected at necessary and con- 
venient distances, their interior hollow and of an inverted funnel 
shape, their height being regulated by circumstances. At their 
tops, or other apertures, a jet of ignited burning gas may be kept 
constantly directed against their openings. Attached to the in- 
terior and upper parts of the sewers, a continuous line of iron 
pipes, kept constantly charged with hot water, should be fixed, to 
more efifectually, safely, and evenly propel the foul air to the flue 
of the chimneys. As the requisite supply of hot water will be 
very small, and its play on the principle of ' water finds its level,"* 
one engine-house will be sufficient for a large district." Mr. 
Elliot, who had not made any calculation as to the expense, asked 
to try his plan on a small scale ; he had not yet made any ex- 
periments. He was not an engineer, and, at present, would not 
give further explanations of his views. The other plan was pro- 
posed by Mr. C. Eginton, of 29, Leicester-square, and is as 
follows : — " A method of sewage by which the formation and 
dispersion of poisonous exhalations from the fsecal matter of our 
sewers and cesspools will be entirely prevented ; the whole being 
gathered in an undiluted form at extramural stations, and treated 
by a cheap chemical process, to obviate the loss of a volatile and 
invaluable ammonia, and so render it presentable to the agricul- 
turist as a dry transportable manure, at the same time freeing our 



PROGRESSIVE ADVANCE. 't'l 

atmosphere and the waters of our rivers from contamination^ and 
bestowing a hitherto unattained degree of fertility upon our land, 
an equal distribution of fruitful agents, and the realization of an 
immense revenue from the refuse which has been hitherto known 
only as a source of misery, disease, and death. The enormous 
expense of erecting high-shaft chimneys for the purpose of carry- 
ing the effluvia from the sewers to high altitudes will be dispensed 
with, as also that of excavating deep canals for manure ducts ; 
the united cost of which plan would construct, according to my 
system, a thoroughly efficient sewage, that would be at once a 
complete sanitary measure, and a lucrative opportunity for invest- 
ment." 

In addition to the case reported by Mr. Jorden, some other 
reputed cases of Cholera had been reported during the summer. 
In Dr. Parkes' report on Cholera, presented to the Board of 
Health, we find that a case had occm'red to Mr. Hallen, of 
Sloane-street, in the early part of July, another to Mr. Howell, 
of Wandsworth, at the end of the same month. On the 18th of 
September, a case occurred to Mr. Russell, of Horsleydown, in 
the person of a sailor, who had just arrived from Hamburgh. 
Eight days later a second case occurred to the same gentleman, 
and two or three days afterwards a third case was treated by 
a neighbouring practitioner. On the 30th of September, a case 
was reported in Lower Fore-street, Lambeth, and in the following 
four days three other cases were seen in the same locality. On 
the same date (September 30th), a case was witnessed by Mr. 
Keen, of Chelsea; and during the next week five other cases 
occurred in the same, or in the adjoining houses. On October 1st, 
a case happened in the practice of Mr. Digby, of Fleet-street. In 
the week ending September 30th, only four cases are reported by 
the Registrar- General ; the average at this time for all cases 
termed Cholera being seven. In the week ending September 7th, 
the number of fatal cases in London termed Cholera had risen 
to thirteen. 

On the 2nd of October, the Cholera broke out, on the river 
Thames, opposite Woolwich, on board the " Justitia " hulk, and 
continued to prevail until the patients were transferred to the 
Unite Hospital Ship, off the Royal Arsenal. There had pre- 
viously been no cases in the Arsenal, or in any part of the town. 



78 PROGRESSIVE ADVANCE. 

From the above date, to October 10, five deaths had occurred, 
all the deceased being convicts. In consequence, the convicts 
on board the " Jnstitia " were permitted to have pipes and 
tobacco to smoke, and tea or cocoa was substituted for their 
usual allowance of gruel ; tea and cocoa were also allowed 
to the convicts on board the "Warrior," opposite the Royal 
Dockyard. In the next week seven deaths occurred on board 
the same hulks. The surgeon attributed the disease to the 
unhealthy state of the atmosphere and to the locality, a common 
sewer being in the immediate vicinity. The captain of the ship 
ascribed it to the rotten condition of the hulk, and to heat gene- 
rated during the night by so many men being closely packed 
together, — a ward containing as many as from ten to twenty-four 
men sleeping in it, according to its size. The last two cases, 
which occurred in this week, were of athletic young men, and the 
disease lasted fom' days. On the 20th of the month, all the 
convicts were removed from the " Justitia" to the "Hebe" and 
" Sulphur," vessels then stationed opposite the Royal Dockyard, 
— an arrangement creating some alarm in the yard.' Beyond this, 
the town of Woolwich remained free from the disease. Scarlatina, 
however, was very prevalent. In the same week, the deaths of 
two boys were registered, from Cholera; the illness of one of 
whom was attributed, by the Registrar, not only to contagion, but 
to miasma generated in a badly-ventilated and comfortless apart- 
ment, and increased by the presence of another sick person, who 
died of the disease. By the 28th of October, the disease had 
appeared at Millbank Penitentiary ; where it proved fatal to three 
prisoners. 

From this period to the end of March, 1849, the Cholera pur- 
sued a steady course, throughout numbering very many victims 
per week. Tlie details attending those cases are of much the 
same character as we have above described. The Registrar-Gene- 
raFs weekly returns presented at this time overwhelming evidence 
of the deficient sanitary condition of the metropolis, and of its 
efiects in augmenting the prevalence and fatality of the epidemic. 

In October, 1848, a meeting of the Common Council of the 
City of London was held, when Mr. Deputy Peacock brought up 
the Report of the Commissioners of Sewers, recommending the 
appointment of a Medical Officer for the City and Liberties of 



THE COMMON, COUNCIL. 79 

London, until January. That document represented, that the 
Court of Sewers had come to the resolution of i-ecommending two 
competent medical gentlemen, of whom the Court of Common 
Council was to select one ; that the successful candidate was to be 
permitted to carry on his private practice, and the Corporation to 
remunerate him from the time of his appointment till the 1st of 
January, when the City Sanitary Act was to come into operation. 
Mr. Peacock, having moved the adoption of the Report, the follow- 
ing conversation took place : 

" Mr. Wire said, such a proposition appeared to him to be a most extra- 
vagant piece of humbug. (A laugh, and loud cries of ' No, no I ' and ' Yes, 
yes!') — Deputy Peacock believed Mr. Wire was the only man in the Court 
who would designate such a recommendation by snch an epithet. (Heai', 
hear.) — Mr. Richard Taylor felt much pleasure in seconding the adoption 
of the Report. Some might think less of the danger than others; but cer- 
tainly, the most eligible course for the adoption of the Corporation, was that 
of precaution. (Hear, hear.) — Sir Peter Laurie heartily thanked the Com- 
missioners for their active and skilful conduct, particularly during the last 
month. He was not one of those who apprehended any serious danger 
from the Cholera ; and he thought it most likely that the City of London 
would maintain its character of being the healthiest city in the world in any 
emergency. The Commissioners had done wisely in determining that the 
medical men to be elected should be allowed to practise ; for nothing could 
be more unwise than to choose a person whose object it would be to seek a 
situation for himself. (Hear.) — Mr. Norris thought it would be advisable 
to defer the consideration of the question until the Commissioners could act 
under the authority of the law. What right would a medical officer, at the 
present moment, have to perform any of the duties set down for his observ- 
ance by an Act which could not be operative for upwards of two months? — 
Mr. Bower looked upon the appointment of a medical officer as merely the 
appointment of a man to do the business of the Court of Sewers. — Mr. 
Anderton said, his surprise was, that such an officer had not been appointed 
years ago. He applauded the permission to the medical officer to practise, 
for such permission would have the effect of collecting for their choice some 
of the ablest men ; while a prohibition would necessarily lead to the offer 
of comparatively unskilful and inexperienced adventurers. (Hear.) — Mr. 
Wire was willing to trust the Commissioners with the health of the City of 
London, without the assistance of a medical officer. The Bill provided 
inspectors to inquire into the existence of nuisances from which diseases 
arose ; and finding that such securities were afforded for the preservation of 
public health, he could not designate the proposition by any other name 
than an extravagant piece of humbug. (No, no.) He did not mean to 
apply the word irreverentially with reference to the visitation of Providence ; 
but he could not help saying, that a vast deal of nonsense and absurdity 



80 FALSE SECURITY. 

were foisted upon the public by persons interested in the excitement of popu- 
lar alarm. (Hear, hear.) What with deodorism and other influences, and 
the most audacious quackery, the ' isle was frighted from its propriety,' and 
the City of London was about to exemplify the ingenious dialogue, in which 
the Cholera was represented as having killed 3000, while the fear of it 
killed 30,000. (Laughter.) — Alderman Lawrence said, it was nothing new 
to appoint a medical man by the Commissioners of Sewers. Before they 
could act upon the representations of the inspectors, they were obliged to 
have the sanction of two medical men. He generally agreed with Mr. 
Wire; but his worthy friend had, on the present occasion, joined in the 
popular cry. (Hear.) He believed there was an unnecessary cry of danger 
raised for interested purposes ; but all believed that the period was near 
when disease would be rife among them, and, in large towns like London, 
there should be a medical officer to watch its approach, and to give con- 
fidence to the public. He had found it necessary to apply to the Metro- 
politan Commissioners to remedy a nuisance in a property of his in Surrey. 
After they had consulted together, they told him they were very sorry they 
had not the power to apply a remedy. (A laugh, and cries of ' Hear, hear.') 
So the Metropolitan Commissioners could not remove one nuisance, while 
the City Commissioners were removing thousands. (Hear, hear.) He 
trusted and he believed the best medical men would be elected ; and he was 
decidedly in favour of allowing the officer to be chosen to practise. After 
some discussion, the following motion was carried : — " That this Court do 
agree with the Commissioners of Sewers that it is highly necessary that a 
medical officer of health be forthwith appointed ; and that a sum for that 
purpose, not exceeding 150/., be paid out of the City's cash; and that the 
Court of Sewers be requested to nominate two fit and proper persons, of 
whom the Court will appoint one, to be the medical officer of health for this 
city and its liberties." 

Viewed in the light of the final catastrophe^ this debate assumes 
a curious importance^ and will, at least, serve to teach the virtue of 
modesty, when the question to be discussed has connection with 
the ways of Providence. 

The Gazette of October 10th, 1848, contained a notification on 
the prevention of Cholera, issued by the General Board of Health, 
under the Nuisances Removal and Diseases Prevention Act. It 
repeated, what had often been asserted before by the authorities, 
that Cholera was not contagious ; so that panic, flight from the 
sick, and quarantine regulations, &c., under that hypothesis, were 
supererogatory evils. The notification warned the guardians of the 
poor and parochial boards, &c., that they would be called upon to 
put the Nuisances Act into operation, and supplied them with 
much useful, distinct, and specific advice as to the modes of doing 



ACTION OP THE POLICE COMMISSIONERS. 81 

SO. The boards were to institute visits from house to house, espe- 
cially in " dangerous " districts (marked out by prevalence of 
Typhus and other epidemics), to enforce the internal and external 
cleansing of dwellings, the removal of filth, decaying animal and 
vegetable matters, and whatever might produce atmospheric im- 
purity ; to give directions for obtaining dryness and ventilation, — 
moisture being regarded as an active cause of Cholera ; to supply 
the poor with information ; to provide them with physic, and to 
remove destitute patients to proper asylums, — general Cholera 
hospitals not being recommended. The document then pro- 
ceeded to the subject of remedies, and other matters concerning 
treatment. 

The Police Commissioners also issued an order, directed to each 
Superintendent of the Metropolitan Police, to make a daily return 
of all cases of Cholera occurring within their respective divisions. 
The form to be adopted was as follows : 

"cases of cholera. 
" No. reported. — Recovered. — Total. — No. attacked yesterday. — Total. 
" These are to be placed in separate columns, and orders are also issued 
directing that every medical gentleman residing in the metropolitan divisions 
which will take in the A, B, C, D, E, F, G, H, K, L, M, N, P, R, S, divi- 
sions, is to be communicated with ; that every case that may come under the 
notice of each individual medical attendant is to be noted down, and that 
one or more men of each division, according to the extent, are to be speedily 
engaged to go round to the respective residences of each sui-geon and obtain 
the returns. The above order is to commence to-day, and the first return is 
to be made to-morrow. The number of persons attacked are to be reported 
by 12 o'clock each day. The Thames Police are to perform the same duties 
among the shipping in the river, and to make a return of all cases which 
occur and are not taken ashore. The object of this order and regulation is 
to obtain a complete and authentic list of the actual amount of cases, as well 
as the condition of the class of persons attacked, thus preventing exaggerated 
reports of persons dying suddenly, or from short illnesses from other causes, 
being termed Cholera. The number of deaths and recoveries are, it is under- 
stood, to be published in an official form from day to day, similar to what was 
done when this dreadful scourge visited the metropolis in 1832. The hospi- 
tals and workhouses are included in the above order." 

On Friday, Oct. 13th, 1848, the Lord Mayor of London, on 
taking his seat in the Justice-room, Mansion-house, said that 
the greatest efforts were being made by the City Commissioners of 
Sewers to enforce the sanitary arrangements of the Board of 

G 



83 



STATISTICS OF THE FIRST 



Health ; and tliat the receipt of a letter that morning from the 
President of the Royal College of Physicians^ had given him much 
satisfaction. This letter was in the following terms : 

" My Lord Mayor, " Dover-street, Oct. 12. 

" Your Lordship, I feel assured, will learn with satisfaction, that the Col- 
lege of Physicians has appointed a Standing Committee, consisting of the 
physicians of the great metropolitan hospitals, and other eminent pei'sons, for 
the purpose of inviting and considering communications on the subject of 
Cholera, and, if necessary, of suggesting such measures and precautions as 
may appear expedient to insure the confidence and safety of the public. 
" I have the honour to be, my Lord, 

" Your Lordship's obedient Servant, 

"J. A. Paris, 
" President of the Royal College of Physicians. 
" To the Right Hon. the Lord Mayor." 

Towards the end of the year 1848_, the intensity of the disease 
appeared to diminish. In the last week of December, 1848, only 
30 deaths were registered — about one half in comparison with the 
first week in November. The retm'ns, however, again rose. In 
the second week of January, 94 deaths were recorded ; but, again 
receding, March closed with only 10 deaths. 

The Statistical History of the disease, then, from Sept. 23, 
1848, to March 24, 1849, may easily be summed up ; and the 
following Table will show the mortality from Cholera in the five 
districts of the metropolis, with their area in square miles : — 



DISTRICTS. 


Area in Square 
Miles. 


Deaths from 
Cholera. 


Proportion of 

General Mortality 

to Population in 

1848, 1 in 


West 


172 

20-5 

2-8 

8-8 

66-2 


86 

71 

49 

262 

523 


37 
36 
38 
30 
32 


North 

Central 

East 

South • . 




55-11 


991 


— 



The -general conclusion to be drawn from this Table is, that the 
mortality from Cholera and the mortality from all other causes 
follow the same law so far as districts are concerned ; thus, the 
City is most highly favoured; the west and north district next; 
and the east and south are the worst in point of mortality ; but, 
contrary to what holds as to all causes, instead of the south being 
more favourable than the east, it is the opposite as regards Cholera. 



OUTBREAK 1848-49. 



83 



In the twentj'^-five weeks, from October 7, 1848, to March 24, 
1849, the deaths from Cholera M^ere: — males, 503; females, 
467 , — total, 970 ; and its fatality at different ages, male and 
female, in the same period, was as nnder : 



AGE. 


DEATHS. 








Male. 


Female. 





66 


68 


5 


102 


95 


10 


58 


40 


15 


58 


34 


25 


52 


69 


35 


57 


63 


45 


46 


41 


55 


41 


25 


65 


19 


22 


75 


4 


10 


85 


— 


— 


95 


— 


— 



The duration of the attack will be seen from what follows 





DEATHS. 


Duration of Attack to Death. 






Males. 


Females. 


hours. 


8 


11 


6 


54 


43 


12 


79 


75 


18 


49 


54 


Under 1 day. 


190 


183 


1 


86 


69 


2 


43 


47 


3 


43 


41 


4 


29 


19 


5 


22 


23 


6 


7 


16 


7 


10 


11 


8 


2 


3 


9 


2 


1 


10 


4 


1 


14 


2 


3 


21 








28 


1 





35 





1 


7 


62 


49 



g2 



84 



STATISTICS OP THE FIRST OUTBREAK. 



The question of atmospheric causes being so much debated 
with reference to Cholera_, we append the following Table, showing 
the number of deaths in each week, with the atmospheric pheno- 



mena attending them 





Number 


Weekly 


Mean Height 


Mean Tem- 




Amount of 




Week end- 


of Deaths 


Average 


of Barometer 


perature 


General Direction of the 


Horizontal 


Rain in 


ing. 


from 


of Five 


from Observa- 


from Obser- 


Wind. 


Movement 


Inches. 




Cholera. 


Years. 


tions. 


vations. 




of the Air. 




Sept. 23 


7 


7 


29 800 


56-7 


Calm 


440 


0-15 


„ 30 


4 


7 


29 476 


56-7 


N.E. 


837 


1-89 


Oct. 7 


13 


1 


29-796 


60-3 


S.W. 


985 


0-26 


„ 14 


30 


1 


29-824 


52- 1 


N. 


1010 


0-42 


„ 21 


45 


1 


29-632 


44-7 


N. 


1075 


0-81 


„ 28 


34 


1 


29-457 


51-5 


S. by E. & S.S.W. 


1290 


1-35 


Nov. 4 


65 


1 


29-423 


44-9 


Variable 


665 


0-89 


„ 11 


62 


1 


29-872 


40-3 


W.S.W.,W.N.W.,&N. 


1070 


0-11 


,' 18 


54 


1 


30-095 


42-1 


N.N.W. & S.W. 


1005 


08 


„ 25 


34 


1 


29-560 


45-5 


Variable 


1450 


0-29 


Dec. 2 


20 


1 


29-740 


46-7 


S.W. 


1685 


0-86 


., 9 


21 


1 


29-444 


49-0 


S.W. 


2040 


0-74 


„ 16 


29 


1 


29-880 


50-2 


S.S.E. 


1145 


0-92 


„ 23 


31 


1 


30-017 


37-5 


E. 


540 


0-07 


„ 30 


30 


1 


29-944 


41-2 




765 


0-44 


1849 
















Jan. 6 


61 




4 


29-847 


30-7 


N.E. 


535 


0-24 


„ 13 


94 




4 


29-528 


39-3 


S.W. 


150 


0-48 


„ 20 


62 




4 


29-783 


46-6 


S.S.W. &S. 


1340 


0-25 


„ 27 


45 




4 


29-979 


45-8 


S.W. 


2215 


0-17 


Feb. 3 


37 




4 


29-952 


40-6 


Variable 


820 


0-52 


„ 10 


55 




4 


30-286 


45-0 


Variable 


1800 


0-06 


„ 17 


49 




4 


30-492 


40-7 


W.S.W. & S.W. 


555 


0-00 


„ 24 


40 




4 


29-814 


45-4 


Variable 


1440 


0-67 


March 3 


35 




4 


29-725 


42-4 


Variable 


^ Instru- 


1-48 


„ 10 


15 




4 


30-096 


43-0 


S.W. & N.W. 




0-12 


" 17 


9 




4 


30-138 


45-9 


N.W. 


> ment 


0-00 


,, 24 


10 


•4 


29-963 


40-0 


N. &E. 


) broken 


0-00 


991 


31-8 









CHAPTER. Vl. 



The Second Outbreak.— 1840. 



On the 21st of April, 1849, it appeared, from the weekly bills, 
that the mortality from Cholera had fallen to its average of five 
Springs — only one death having been registered from that cause, 
in the week ending on the above date. This cheering result, how- 
ever, was accompanied by a plain indication that the general health 
was by no means in a satisfactory state. In the same week 
there was a considerable excess of mortality over the weekly average 
of Spring, from all causes ; while, from diarrhoea and dysentery, 
nine deaths more than the average occurred. On the 5th of May, 
the Registrar-General reported, that the " Summer approaches, 
and brings with it the usual improvement in the public health." 
AlTiile this statement, however, might be perfectly correct as to 
deaths from all causes, it was yet evident that the Cholera had 
only succumbed under the influence of an extraordinarily low 
temperature; in the week ending April 21st, the thermometer 
had marked 37° Fahr. ; in the week ending May 5th, it had 
risen to 55°, and, coincident with this rise, four deaths from 
Cholera and twenty from diarrhoea, were reported — in all eleven 
above the average. But while it may be natural to attribute a part 
of this result to atmospheric influences, it ought to be borne in 
mind, that conditions were still existing, within the range of 
human efi'orts to remove, which depended mainly on the pre- 
vailing temperature to produce their deadly efiects. Notwith- 
standing the lesson which had been taught, towards the close 



86 THE SECOND OUTBREAK. 1849. 

of the year 1848, well-considered sanitary arrangements were still 
wanting. In the week ending May 5tli, respecting one of 
the four deaths from Cholera, Mr, Earles, the Registrar, states, 
that " the health-officer of the parish and himself visited the house 
in which this case occurred, and found twenty-six persons living in 
it, of whom eight slept in the garret in which the child died. They 
attribute the disease to extreme poverty, bad ventilation, and the 
noxious effluvia arising from the gorged state of the cesspools. 
Another child has since died in the same room, upon which an 
inquest is about to be held.^' In the week ending June 9th, the 
deaths from Cholera had risen to twenty-two ; while those from all 
causes exhibited an increase of nearly eighty on each of the two 
preceding weeks. One of the deaths from Cholera, (and which 
occui'red in Bermondsey,) is thus referred to by the Registrar of 
the district : " The case occurred in a house overhanging the 
filthy and disgusting tidal ditch. Other cases have occurred on 
the same spot, two of which have proved fatal, but are not yet 
registered." The Jury expressed, in no measured terms, their 
opinion of the Commissioners, " who having recently had the oppor- 
tunity of purchasing this tidal ditch, and the power of closing up 
the present large open drain, refused to do so, from a trifling pecu- 
niary consideration, leaving the thousands of persons who reside 
upon its banks to suffer from the pestiferous effluvia constantly 
arising therefrom." And again, in respect to this same ditch, on 
the next week, nine cases of Cholera are reported in Bermondsey, 
and are thus referred to by the Registrar : " All the nine cases of 
Cholera reported this week, occurred on the banks of the disgust- 
ing tidal ditch mentioned in last week's report. Seven of them 
occurred within fifty yards of each other. This ditch, formerly 
used as a mill-stream, is now the receptacle of all kinds of filth. 
Putrid fish in large quantities is frequently thro\^^l in ; many of 
the poor drink the water, and use it for culinary purposes." 
From May 19th to the week ending August 11th, the deaths 
from Cholera had been respectively, in the thirteen weeks, 1, 
5, 9, 22, 42, 49, 124, 152, 339, 678, 783, 926, and 823. 
Of this latter number, no less than 819 were certified by the 
medical attendants; but the Registrar-General well observes, — 
' It is to be feared that the advice was not obtained in time. The 
accounts of the sudden stoppage of the epidemic by prompt medical 



THE SECOND OUTBREAK. 1849. 87 

treatment^ and the lionse-to-house visitation^ are perhaps over- 
coloured. But a mortality as liigli now as in 1832 should not 
take place ; it may be prevented by improvements in the treat- 
ment, by arresting the premonitory symptoms, by still earlier 
attention to the general health. Medical men are called when the 
people are dying; but it is then too late. If the families of the 
middle and higher classes were seen at intervals during the epi- 
demic by their medical attendants, and a corps of medical officers 
employed by the Guardians to visit the poor at short intervals, the 
present epidemic might very probably be cut short, and a third 
eruption be averted. The precise locality in which almost every 
victim of Cholera lived is given in the present return under each 
district ; would it not be practicable for the authorities to have all 
these and the neighbouring localities inspected? If this were 
done, and proper precautions taken, the tragedies of Albion-terrace, 
Wandsworth-road, where seventeen persons died in two weeks in 
ten houses, could scarcely recur. In the house. No. 6, Albion- 
terrace, five deaths had been registered — a Wesleyan minister's 
wife, aged 59 ; his mother, 80 ; a widow, 49 ; and two old ser- 
vants. This is all we learn from the Clapham Registrar. The 
Registrar of Hampstead adds ; — that during the week an aged man 
came mth a friend to Hampstead for change of air ; breakfasted, 
dined, went to London to transact business at the Bank of Eng- 
land, and after his return seemed ^pretty well.' About six 
o'clock the next morning he felt ill, and had medical advice, but 
died in eight hours. This old minister was apparently the last of 
his family, — for he had seen his mother, wife, and servants die 
before him in Albion-terrace, and could not fly from the poison 
which he carried in his breast. Such scenes of desolation could 
scarcely happen without great negligence on the part of the 
people themselves, and on the part of the authorities." 

The deaths from the prevailing epidemic had now (August 18) 
reached the terrible number of 1,230, besides 188 from diarrhoea, 
and the details of these cases, in the weekly bill of mortality, 
occupied ten crowded folio pages In the next week, the Cholera 
numbered 1,272 victims. The Registrar's observations at this 
date (August 25) are so valuable and just, that we feel it would 
be a dereliction of duty on the part of the chronicler, were we to 
omit them. He observes : 



88 THE SECOND OUTBREAK. 1849. 

" The energy with which parts of our institutions work, makes the defects 
of the rest more evident. On August 9th last, a man was murdered in Ber- 
mondsey ; and before his death, reported by the coroner^ will appear in these 
returns, one — and it is probable both — the persons charged with the murder, 
will be in custody. Steam-ships, the electric telegraph, the heads of police, 
and professional agents, specially chosen, were all employed to arrest the 
destroyers of this life ; the columns of the newspapei's were filled with the de- 
tails of the death. On the same day (August 9th), a stockbroker died at 
No. 12, Albion-terrace, Wandsworth-road ; a widow lady, and an old domes- 
tic servant, at No. 6 ; in the five preceding days, in the same teiTace, the 
daughter of a grocer, a child of five years of age, had died at No. 1 ; the 
widow of a coach-proprietor, and a commercial clerk, at No. 2; a gentle- 
man's widow at No. 3; a surgeon's daughter at No. 4 ; a spinster of forty 
one, at No. 5 ; the wife of a dissenting minister, his mother, a widow lady, 
and a servant, at No. 6 ; a young woman of twenty-one, at No. 10 ; a gen- 
tleman at No. 12, where the stockbroker died; a commercial clerk and a 
young woman of nineteen, at No. 13, where a young woman also died on 
July 28th; a gentleman's wife at No. 14, who had seen her daughter die the 
day before. The nineteen persons died of Cholera, many of the inhabitants 
of the terrace were indisposed, and the deaths of several have been regis- 
tered elsewhere. ' It appears,' says the registrar, Mr. Frost, 'that at No. 13, 
inhabited by Mr. Biddle, where the first death occurred, and where two 
deaths were afterwards registered, the refuse of the house had been allowed 
to accumulate in one of the vaults (which is a very large one), for about two 
years ; and when removed last week, the stench was almost intolerable, there 
being about two feet of wet soil, filled with maggots ; the drains had also 
burst, overflowed into the tank, and impregnated the water with which the 
houses were supplied. On the back-ground, in the distance, was an open 
ditch, into which nearly the whole of the soil of Clapham runs.' As turpen- 
tine to flames, so is the exhalation of such cellars, tanks, and sewers to 
Cholera ; it diffused itself rapidly, attacked many, and nineteen inhabitants, 
after some hours of suffering, sickness, and spasms, expired. 

" The effects of decomposing refuse and water on health were well known ; 
their fatal subsidies to Cholera had been heard of every day ; yet no steps 
had been taken for their removal from Albion-terrace in July ; no medical 
police had interfered to disturb the contents of Mi*. Biddle's cellar. And now 
the nineteen, masters, servants, parents, children, rest in their graves, it 
appears to be taken for granted that blame attaches to nobody, — to nothing, 
— to the householders themselves — to the guardians of the district — to the 
institutions of the country ! Such mean, intangible instruments of death 
can be invested with no dramatic interest ; but, fixing our eyes on the 
victims, it is well worth considering whether substantially it is not as much 
a part of the sound policy of the country that lives like those in Albion- 
terrace should be saved, as that the murderers of the man in Bermondsey 
should be hanged ? 

" The revelations of the state of their districts in the registrars' notes of this 



THE SECOND OUTBREAK. 1849. 89 

and last week, prove that it will be no easy task — I say, not to stay the plague 
of Cholera, for it will subside, but to remove the evils which make Cholera 
and all epidemics fatal. The vast task of the physical melioi-ation of the 
population, demands the energies of the best men in Her Majesty's dominions. 
When, in the country from which Asiatic Cholera came, our armies seemed 
for a moment worsted, and the empire threatened, the great Captain of the 
age is reported to have addressed to another the memorable words, ' If you 
do not go, I must.' That enemy was distant. We have one very near in 
our streets, of which Cholera, a servile minister, has destroyed, already, 
4,470 lives in London, and thousands more in the rest of the kingdom. Who 
will go out against this enemy ? Is it too powerful or too feeble for the arm 
of the greatest? Will no glory crown its conquest? Is the country insensible 
to its magnitude ? Will not all the national strength and resources be put 
forth to improve the hygienic condition of the people, and to rid England of 
the causes of the fatality of epidemics? This may yet be done by the 
Government, aided by the force of facts and of enlightened public opinion." 

The montli of August^ 1849, having been so fatally distin- 
guished by the progress of the Cholera, it will be a valuable 
addition to our knowledge to note the various phenomena of the 
weather during that period. It appears from the observations of 
Mr. Glaisher that, till the 12th, the air was in very little motion ; 
from the 12th to the 16th it moved rather quickly, and from the 
17th it was frequently in a calm state. At the beginning of the 
month the sky was often cloudy, but, at times, free from clouds ; 
during the latter part of the month it was nearly always overcast, 
accompanied with a very angry atmosphere ; at times the haze 
and mist were so dense as to cause a great gloom. During the 
last seven or eight days of the month, London was not visible from 
Greenwich Park ; it was hidden by a dense fog-like mist, which 
hung over the city. After the first few days of the month the 
temperature ranged high, and towards the end the air was close 
and oppressive ; scarcely any rain fell ; the atmosphere was dry ; the 
reading of the barometer at the height of 159 feet ranged from 
29-46 on the 13th, to 30-22 on the 22nd ; the temperature of the 
air varied from 42-4 to 82*5, thus exhibiting a difiference of read- 
ing within the month of 40-1 ; on some days, at the beginning of 
the month, the difference of temperature on the same day exceeded 
30° J the average difference of day and night from the 22nd was 
17°. The average value of the several subjects of meteorological 
research for August, for a series of years, are shown in the sub- 
joined table. 





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THE SECOND OUTBREAK. 1849. 91 

From the above numbers it appears that the reading of the 
barometer exceeded the average by 0"063 inches, and that the 
water mixed with the air counterbalanced a column of mercury 
of less than its average height by 0*030 inches, and therefore the 
pressure of diy air exceeded its average value by the sum of these 
two quantities, viz., by 0*093 inches ; the temperature of the air 
exceeded the average by 2''"1. The average value from seventy 
years is 60*8 ; the years in which the averages for August have been 
as high as in this year are 1778, 1800, 1802, 1807, 1818, 1819, 
1826, and 1846. Notwithstanding this high temperature of the 
air, the point of evaporation and dew-point were below their average 
value, and consequently there had been less than the average 
weight of water mixed Avith the air; the additional weight of 
water required to saturate a cubic foot of air was 1*8 grains; the 
average quantity is 1 grain, — this implies great dryness ; the 
degree of humidity of the air was 0*727 only, its average value 
being 0*110 more. No August in this series of years had been 
so dry ; the sky was more clouded than usual ; rain fell on 
three days only, and the amount collected was less than half 
an inch ; so small a quantity of rain had not fallen in August 
since the year 1819. The number of days on which rain fell in 
August, 1848, was 29, and the amount collected was 4} inches. 
The amount of electricity in the atmosphere was small throughout 
the month. 

In the week ending September 1, we have recorded 1,663 deaths 
from Cholera, against an average of 8 for five summers ; this made 
up an aggregate number of deaths from the first breaking out of 
9,129 ; and in the next week, we have the highest number, viz., 
2,026 individuals in seven days cut off" by this one disease. For 
the week ending September 15, the mortality had decreased to 
1,682; in that week^s bill of mortality the Registrar- General 
observes : — 

" On Sunday, the inhabitants of these islands, in the city and the country, 
in their cathedrals, village churches, and chapels, assembled to entreat God 
to stay the destroying plague, and, as if by anticipation, it began to subside ; 
so that the time was most appropriate. After they had been journeying 
through the gloom, while the darkness grew thicker, the terror greater, the 
strokes of mortality nearer, and everywhere uncertain, the light began to 
dawn, and the prayer — half supplication, half thanksgiving — rose of itself 
from the hearts of the people. These great acts of religion are rarely per- 



92 THE SECOND OUTBREAK. 1849. 

formed in England ; and whether the earnestness of the nation, or the truth 
of God is regarded, the prayer for health has a much more serious import 
here than the ceremonial rites of paganism in Persia, Greece, or Rome ; yet 
there it would have been deemed impiety to ask the increase, or the earlier 
and later rains, unless the land were tilled and the seed sown ; or to implore 
victory for their arms, except through the valour of well- equipped armies. 
The prayer for the public health in England is a solemn pledge, not only that 
all the powers of the State, but that the local authorities, the clergy, the edu- 
cated classes, who form and govern opinion — all the multitudes who join in 
that prayer — will employ the means which, with God's blessing, will insure 
its accomplishment, and save the people from the ravages of the Cholera and 
other epidemics. 

" Thousands of the houses of London have now no pure water ; in some 
places, where the Cholera is most fatal, the inhabitants are driven to use the 
polluted waters of tidal sewers for culinary and household purposes. This 
state of things will exist no longer ; the first engineers of the country will be 
employed to lay the rivers under contribution, and in every house there will 
be a spring of fresh, filtered, living water ; for circulating water is the life- 
blood of a city. The bodies of the dead, 'sown in corruption,' will be 
decently interred in distant grounds and sacred groves, where their flesh may 
be resolved into its elements, without tainting the air and destroying their 
brothers. The carnage of slaughtered animals will no longer be suffered to 
infect the air of cities. The sinks and sewers of London — black, bubbling 
lakes and rivers under-ground, extending from the Thames to the house- 
drains and cesspools — send up damps into dwellings nightly, travel by us irt 
the streets daily, and through a thousand mouths, by the way and river-side, 
pour their poisonous incense on the passengei's for ever ; these emanations, if 
not drawn through and decomposed by fire, will no longer open under our 
faces, but ascend with the smoke over the houses, and other matters be 
carried solid or in streams of water, over distant fields." 

On Saturday, September 22nd, the mortality from Cholera had 
again diminished, and that to half the amount of the previous 
week ; again, in the next week, it fell to 434 ; then weekly, to 288, 
110, 41, 25, 11, 6, 8, until the week ending November 24th^ 
when it fell to 2, — ^being six under the average of five autumns. 

The 15th of November was appointed for a general thanksgiving 
to God, " to acknowledge his great goodness and mercy in remov- 
ing from us that grievous disease with which many parts of this 
kingdom have been lately visited,^' when the following form of 
Prayer and Thanksgiving was issued, by Her Majesty's Special 
Command, for use in all Churches and Chapels in England and 
Wales, and in the Town of Berwick-upon-Tweed : 

" Acctpt, wo beseech Thee, O merciful God, the praises and thanksgivings- 



THE SECOND OUTBREAK. — 1849. 93 

of Thy people, whom Thou hast graciously relieved from the sore judgment 
of grievous sickness and mortality which has lately afflicted our land. Incline 
us to devote to Thy service the lives which Thou hast spared ; and so en- 
lighten our understandings and purify our affections by Thy Holy Spirit, that 
we may learn from Thy judgments to fear Thy wrath above all things, and 
may be led by Thy goodness to love Thee with our whole heart, through 
Jesus Christ our Lord. Amen." 

Andj 

"Almighty God, our Father and Judge, whose power no creature is able 
to resist ; who hast in Thy displeasure brought us down to the gates of death, 
and in Thy mercy hast stayed the course of that pestilence, for which there 
was no help in man : to Thee alone we ascribe our deliverance ; in Thee only 
do we trust, to preserve us both in body and soul. And now, O Lord, we 
entreat Thee to make the chastisement which Thou has sent effectually to pro- 
duce in us a more lively faith in Thy word, and more entire obedience to Thy 
commandments. Make us so duly sensible of Thy mercies to this nation, in 
maintaining our domestic tranquillity, and in granting a plentiful return to 
the labours of our husbandmen, that we may show our thankfulness by an 
earnest endeavour to conform to Thy will, and to advance Thy glory. And 
may the frequent instances of mortality which we have beheld, remind us all 
of the nearness of death, and dispose us so to number our days, that we may 
apply our hearts unto wisdom ; that, whether living or dying, we may be found 
faithful disciples of Him who has taken away the sling of death, and opened 
the gate of everlasting life to all believers, 

" Hear us, O Lord, for thy goodness is great ; and according to the multi- 
tude of Thy mercies receive these our petitions, through Jesus Christ our 
Lord. Amen." 

On this occasion^ as on the day of humihation before referred 
to, several eminent divines gave full expression to their sentiments 
regarding the condition of the population of London, referring its 
evils to influences which wei'e within the power of man to remove. 

Our next duty will be to consider the whole returns of the mor- 
tality from Cholera, and draw from them whatever practical conclu- 
sions they may aflbrd. It is almost needless to say that for the 
greater part of this information we are indebted to the Registrar- 
General of Births, Deaths, and Marriages, whose reports are not 
only the sole source to which we could apply, but are worthy in 
the highest degree of public confidence both in virtue of the 
spirit which pervades them and their great accuracy. 

And first, we give the following Table of the Deaths registered 
from Cholera during a period of twenty-six weeks, in each 
Superintendent Registrar's district, from the week ending May 
26th to the week ending November 17, 1849. 



TABLE OP THE DEATHS FROM 

With their Population hy the Census of 1841, their 



LONDON . 



West Districts 

North Districts.... 
Central Districts. 

East Districts 

South Districts .... 



. /Kensington . 
o I Chelsea 



% I St. George, Hanover-square.. 

^ 1 Westminster 

M St. Martin-in-the-Fields 

St. James, Westminster 



Marylebone 
Hampstead . 

Pancras 

Islington .... 
Hackney 



« 



fSt. Giles 

Strand 

Holbom 

Clerkenwell .. 

St. Luke 

East London . 

West London 
^London City.. 



Population 

by the 

Census of 

1S41. 



Estimated 
Population 
totheMiddlt 
f 1849. 



1,948,425 

300,711 
375,971 
373,653 
392,444 
501,190 



74,779 
40,179 
60,552 
56,712 
25,091 
37,398 



138,164 

139,856 

55,690 
42,261 



54,292 
43,598 
44,461 
56,756 
49,829 
39,655 
29,142 
55,920 



2,206,076 

346,509 
444,448 
384,213 
445,859 
585,447 



98,320 
48,392 
74,533 
62,881 
25,049 
37,334 



151,706 

• 11,457 

.154,152 

70,919 

50,214 



54,199 
43,524 
44,386 
65,725 
51,874 
39.588 
29,092 
55,825 



Area in 
Englisli 
Statute 
Acres. 




2680 
780 



2500 



2600 
3050 
3300 



320 
240 



.^lay. 



^Shoreditch 

Bethnal Green 

Whitechapel ,... 

St. George-in-the-East 

Stepney 

Poplar 



83,432 
74,088 
71,765 
41,350 
90,687 
31,122 



90,272 
85,109 
77,199 
43,142 
107,408 
36,729 



620 
760 
160 
230 
2130 



f St. Saviour 

St. Olave 

Bermondsey 

St. George, Southwark . 

Newington 

Lambeth 

Wandsworth 

Camberwell 

Rotherhithe 

I Greenwich 

^-Lewisham 



32,975 
18,479 
34,947 
46 644 
54,606 
115,888 
39,868 
13,917 
80,997 
39,855 
23,014 



32,919 
19,804 
39,672 
52,004 
64,137 
143,557 
46,054 
52,246 
13,894 
93,964 
26,796 



630 
3040 
1820 
4570 

690 
2030 
1003 



CHOLERA IN EACH DISTRICT. 

estimated Population in 1849, and their Area in Statute Acres. 





July 
U. 


678 


July 

23". 


Aug. 


\ug. Aug. 
11. ] 18. 


Aug. 
25. 


Sept. 


Sept. 


Sept. 
15. 


Sept. 

22. 


Sept. 
29. 


Oct. 
6. 


Oct. 
13. 


Oct. 

20. 


Oct. 

27. 


Nov. 
3. 


Nov. 
10. 


Nov. 

17. 


Total of 59 

weeks 

from Oct. 1, 

1848. 




783 


926 


823 1120 


1272 


1663 


2026 


1682 


839 


434 


288 


110 


41 


25 


18 


6 


8 


14588 




29 


46 


43 


58 


54 


81 


103 


169 


181 


172 


68 


72 


39 


15 


4 


1 


11 




1 


1258 




17 


7 


25 


27 


45 


71 


114 


123 


157 


121 


71 


37 


27 


7 


1 


4 


1 


1 


1 


965 




55 


72 


97 


93 


116 


167 


185 


194 


227 


213 


95 


51 


25 


10 


6 


1 


3 




2 


1739 




46 


110 


104 


127 


132 


356 


393 


447 


290 


330 


183 


113 


91 


32 


17 


15 


3 


1 




3218 




192 
3 


443 
4 


514 


621 


476 


554 


477 


730 


1071 


846 


422 


161 


106 


46 


13 


4 


1 


4 


4 


7048 




5 


5 


13 


12 


16 34 


38 


51 


13 


15 


13 


6 








... 




266 




4 


3 


14 


12 


5 


20 


28 29 


48 


39 


12 


14 


5 


2 


1 




1 






266 




8 


4 


3 


15 


9 


6 


11 


10 


18 


21 


5 


7 


8 


2 












131 




10 


30 


20 


17 


17 


34 


36 


75 


56 


42 


25 


27 


10 


3 


2 








1 


447 




2 


3 


1 


8 


6 


7 


8 


10 


9 


13 


8 


5 


2 


2 


1 


1 


2 






90 




2 
11 


2 
4 




1 


4 


2 


4 


11 


12 


6 


5 


4 


1 














58 




6 


10 


7 


24 


34 


41 


51 


28 


14 


10 


5 


1 


1 








1 


259 










1 


2 


3 




2 


1 






















9 




1 


1 


10 


8 


19 20 


45 


54 


56 


48 


32 


9 


8 


1 




2 


1 






355 




3 


2 


6 


4 


14 


15 


22 


15 


33 


35 


19 


8 


3 




... 


1 




... 


... 


195 




2 
5 


13 


3 


4 


3 


9 


13 


11 


16 


10 


6 


10 


11 


5 




1 




1 


... 


147 




6 


15 


35 


28 


28 


30 


57 


45 


8 


6 


1 




1 


... 








280 




1 


4 


13 


7 


17 


22 


19 


15 


21 


17 


10 


2 


4 


2 


1 








1 


160 




12 


9 


5 


8 


8 


12 


21 


9 


20 


15 


4 


2 


3 








1 






161 






2 


5 


4 


6 


16 


10 


18 


15 


20 


10 


6 


3 


1 










1 


125 




3 


8 


5 


11 


8 


13 


24 


22 


28 


33 


9 


9 


2 


3 












187 




5 


3 


9 


13 


14 


18 


20 


22 


28 


17 


14 


3 


8 


1 


2 


1 


2 






185 




20 


18 


35 


32 


18 


40 


35 


45 


42 


43 


21 


19 


4 


2 


2 










432 




7 


15 


19 


3 


10 


18 


28 


33 


16 


23 


19 


4 




1 












209 




4 


6 


17 


17 


21 


98 


121 


139 


109 


91 


52 


31 


29 


12 


5 


3 


2 






796 




5 


5 


10 


16 


35 


125 


127 


128 


96 


91 


36 


28 


15 


7 


5 


3 




1 




807 




7 


14 


20 


30 


28 


45 


55 


74 


58 


48 


39 


17 


20 


4 


2 


2 


1 






548 




11 


7 


9 


16 


16 


17 


10 


15 


27 


18 


6 


5 


8 


1 




4 








210 




11 


35 


22 


31 


24 


55 


58 


64 


59 


49 


30 


17 


11 


3 


4 


1 








525 




8 


43 


26 


17 


8 


17 


22 


27 


41 


33 


20 


15 


8 


5 


1 


2 








332 




14 


14 


32 


46 


47 


57 


52 


65 


75 


49 


29 


15 


6 


6 


1 






1 




547 




4 


23 


26 


38 


28 


28 


25 


41 


44 


33 


16 


10 


6 


2 










... 


363 




23 


64 


64 


67 


56 


5C 


53 


70 


101 


72 


32 


9 


10 


6 


1 


1 




1 


1 


771 




16 


51 


70 


112 


62 


7S 


57 


77 


109 


108 


58 


10 


8 


7 


3 


1 


1 






872 




13 


53 


66 


86 


55 


6J 


65 


93 


157 


137 


66 


15 


15 


2 








1 




927 




49 


106 


HI 


143 


84 


9£ 


89 


180 


279 


234 


117 


50 


24 


7 


2 


1 




1 


2 


1653 




5 


13 


22 


29 


48 


34 


19 


31 


48 


31 


10 


5 


5 


7 












510 




12 


37 


43 


43 


32 


3C 


35 


56 


109 


53 


16 


10 


7 




3 


1 








534 




37 


37 


31 


14 


25 


2* 


21 


20 


40 


32 


18 


7 


4 




2 










372 




12 


31 


44 


37 


32 


8( 


56 


8£ 


93 


90 


54 


30 


19 


8 


1 








1 


762 




7 


1-^ 

1 


5 


C 


7 


1 = 


f 


16 


7 


6 




2 


1 












97 



96 THE SECOND OUTBREAK. 1849. 

With reference to the localities in which Cholera especially pre- 
vailed, we quote from a paper ^' On the Health of London during 
the Six Months terminating 29th of September, 1849/' by John 
Webster, M.D., F.R.S., in which that gentleman remarks : 

"The worst localities were the low grounds adjoining the southern hank of 
the Thames. Notwithstanding the total population of this district being only 
about one-third of that on the northern side of the river (or 580,000 inhabit- 
ants), more than half the deaths by Cholera, or 6,708, out of the entire 13,114 
registered, took place in the southern division of the metropolis; which makes 
the amount of deaths, in proportion to the population, treble of that recorded 
on the northern side of the river. 

" Having adverted generally to the rate of mortality in the two great 
divisions of the capital, it now becomes interesting to notice the difference 
observed in several of the districts situated south of the Thames, as well for 
local comparison, as afterwards to contrast the amount of deaths there recorded 
with that met with in places lying north of the river, where a great discre- 
pancy in the averages is often exhibited. For instance, in Lambeth parish, 
the deaths by Cholera were 1,570 during the last six months; the ratio was, 
therefore, one in every ninety-one inhabitants. In St. George's, Southwark, 
where Cholera proved fatal to 811 individuals, one person died in every sixty- 
four of the population ; whilst in Bermondsey, with its tan-pits, glue-yards, 
tidal- ditches, and other local nuisances, injm-ious to the health of the labouring 
population resident in that insalubrious part of London, not less than 704 
persons died by Cholera ; so that the very large proportion of one in every 
fifty-six inhabitants became victims to the pestilence. But even this exces- 
sive mortality was exceeded by the numbers registered in the parish of 
Rotherhithe, where one death from Cholera actually took place in every 
thirty-eight inhabitants. Such an amount of deaths, seldom, if ever before 
witnessed, is most remarkable ; and shows the extraordinary severity of the 
epidemic in that section of the metropolis." 

The following Chart points out the relative positions of the dis- 
tricts in which Cholera prevailed, taking the level of the Thames 
at high water as a point of comparison : it also exhibits the rate of 
mortality from Cholera in each district, and the sources whence 
the supply of water to each was derived. 



M CHnwrNr THE DEATHS TO EVERY 10,000 INHABITANTS IN EACH DISTRICT OF LONDON, IN THE FIFTY-TWO WEEKS, ENDING SEPTEMBER 29, 1849 ; THE WATER COMPANIES SUPPLYING 
DIAGRAM »""j;'" „ AVERAGE ELEVATION OF THE INHABITED PARTS OF THE DISTRICTS ABOVE THE TRINITY HIGH-WATER MARK, AS ESTIMATED BY CAPTAIN DAWSON, R.E., 



FROM THE MAP OF THE COMMISSION OF SEWERS. 



NORTH SIDE OF THE RIVER. 



Htmpitud 

c. 8 
W.M. H. 

I. 100 
Man-lebone 

<•'. 17. 
W.M. G.J. 

.■.■19 



KcnBington, 

Brompton, 

Hammornnntli, 

and 

Fulliam 


lU 


lover-squ 

and 
May-fair 

c. e 

G.J. 




c.SS 








W.M. C. G.J. 








e. 12 
ChoUca 
C.63 


>. 19 

f Belgravia 

C.28 


e.2 

Westminster 

C.69 





e.SO 




e. 88 






Pancras 




Islington 






c. 22 




e. 25 




N.R. H. W.M. 




N.R. 




f. 43 


«. 68 


e. 53 


e. 63 


e. 48 


St. James 


St. Giles 


Holborn ClerkenwfU 


St. Luke 


c.U 


c. 51 


c. 35 


c. 18 


c. 48 


G.J. N.R. 


N.R. 


N.R. 


N.R. 
London City 


N.R. 


e. 35 


t. 50 




c. 49 or c. 65* 




St Martin- 


Strand 




N.R. 




in-the-Ficlds 

C.8S 

C. N.R. 


c. 35 
N.R. 


c 


e. 28 c. 38 
West D. City D. 
79 or 146* e. 37 

N.R. N.R. 


c. 42 

East D. 

e. 43 

N.R. 



Bouteo olT^rVi", Weil MlddlcMi Source of,„ , Cheltea 
Supply I"- "'WattrCoinpany Supply '-^Company 

Source of^rSouthwark 

e. 22 

Wandsworth 

c. 70 

eluding; the deatlis from Choler 

in Mr. Drouot's establishment 

c. 108 



St. Saviour 
c. 162 
L. S. 



e.SS 

Hackney 

c. 26 

N.R. E.L. 



Shoreditch 

c. 71 
N.R. E.L. 



Whitethapel 

c. Ii7 
N.R. E.L. 



Bethnal-grcen 
r. !ll 
E.L. 



St. George, Southwark 
c. 164 
L. S. 

t 2 below high water 

Newington 

c. 142 



SOUTH SIDE OF THE RIVER. 



Abbreviations 
used in 
the Table. 


CompaSta. Sources of Supply. . 


H. 

W.M. 

C. 
G.J. 
N.R. 
E.L. 

L. 

S. 
E. K. 


Hampstead ... By springs on the hill. 
West Middlesex Thames, Hammersmith. 

Chelsea Thames, Battersea. 

Grand Junction Thames, Kew Bridge. 
New River.... Rivers Amwell and Lea. 
East London . . River Lea. 

Lambeth Thanies.Waterloo Bridge. 

Southwark Thames, Battersea. 

East Kent . . . . ' Ravensbourne River, near 
1 Deptford Common. 



Stepney 
C.47 
E.L. 



Poplar 
c. 86 
E.L. 



Greenwich 

C.7S. 
E.K. 



West District. The 65 and 14G include the deaths In St. Bartholoi 



Hospital i 

square, comprises the sub-districts of Hanover-square, May-fair, and Belgravia. 



* Ths CII7 of London within and without the walls is divided into three Unions for the relief the poor, making three Registration districts, — the City, the West, and the East. Bartholome' 
Hospital, Into which many of the patients were brought from other parts, as well as ftom the West London District. 

f For RogUtratton purposes Paddlngton I* united with the Sub-districts of Kensington, Brompton, Hammersmith, and Fulham, under the name of Kensington. The district of St. George, Hano' 

t Including the deaths in St. Thomas's Hospital, the morlaltly (Tom Cholera in St. Olave was I7<j. 

The death* of several children who were rvmove<l ttom Mr. Drouct's establishment at Tooting, in the Wandsworth district, occurred and were registered in other districts of London. The deaths from Cholera in St. Luke's workhouse 
to St. Luke's district in the calculations. 

Abbreviations.— c. denotes deaths flrom Cholera to 10,000 living ; e. denotes elevation In feet above Trinity high-water mark ^ the other letters denote the several Water Companies supplying each di 



: transferred from the Shoreditch distri 



THE SECOND OUTBRExVK. 1849. 97 

And while we have the above pamphlet before us, we cannot 
forbear quoting the same author as to the preventive measures 
which he suggests in reference to the sanitary state of London 
he has so well described. He says : — 

" First, then, I would most decidedly say, intramural interments mnst be 
interdicted throiigliout the kingdom. Drainage must be extended in denselj'- 
peopled neighbourhoods. Slaughter-houses must be removed from the 
crowded haunts of men ; and public markets properly regulated, frequently 
cleansed, anj, wherever practicable, placed in open, airy situations. Common 
sewers must be scientifically constructed, so as not to act as the conduits of 
disease. The Thames must no longer continue to be the cloaca maxima of 
London, especially as its filthy contents, by quadruple diurnal agitation, are 
rendered in a higher degree noxious to the neighbouring inhabitants, and to 
the many thousand persons who daily use the river as a metropolitan thorough- 
fare, 

" Habitations in low, damp, and confined localities should be avoided, or 
made more salubrious by artificial means. The physical well being of the 
population, especially the poor and labouring portion, must be improved. 
Tiie light of the sun, and the admission of pure air into every dwelling, ought 
not to be taxed or impeded, but in every manner promoted, especially by a 
Government endeavouring to improve the public health. As the Imperial 
Legisiature has sanctioned the importation of all kinds of food into the 
country without any duty, in order to increase the sustenance of the commu- 
nity, so ought it to permit the untaxed entrance of light and pure air, both 
being as indispensable as corn and mutton to the healthful maintenance of 
animal life and mental vigour. Good water should be supplied for every 
purpose, more particularly in densely-crowded districts; and localities known 
as the hot-beds of disease must be cleansed from all abominations. 

" Many other important sanitary measures might be mentioned, were their 
necessity not so obvious. This much, however, I would here strenuously 
assert. All nuisances, whether public or private, must be abated, and vested 
rights and individual interests must give way to the health of communities. 
On these points, ' salvs reipuhliccB^ is ' iuprema lex;' and, as on such questions 
there can be no mistake, there ought assuredly to be no compromise." 

The following Table shows the mortality from Cholera for 1848- 
9, and the annual mortality from all causes during 1838 to 1844 ; 
with the elevation of the dwellings above high water-mark, the 
average annual value of houses, and the average cost of house- 
room, in the districts of London, supplied by the nine Water Com- 
panies included in the foregoing diagram, with the several districts 
in the above groupe : 



98 



THE SECOND OUTBREAK 1849. 



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tJC I-, c 

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5 c 3 232 



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THE SECOND OUTBREAK 1849. 



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100 THE SECOND OUTBREAK. 1849. 

The influence exercised by the quality of the supplied water over 
the course and mortality of Cholera is indicated in the following 
summary remarks : 

Grand Junction Company. — The mortality from Cholera was at 
the rate of 10 in 10,000 inhabitants. The lowest rate was 6, the 
highest, 16 in 10,000. 

West Middlesex Company. — The mortality from Cholera was at 
the rate of 1 7 in 10,000 inhabitants. In Hampstead, the mortality 
was 8 in 10,000. 

Chelsea Water Company. — The mortality from Cholera was at 
the rate of 56 in 10,000 inhabitants ; in the Belgrave sub-district, 
the deaths from Cholera were 31, in Chelsea 55, in Westminster 
71, in 10,000 inhabitants. 

Southwark Company. — The mortality was at the rate of 156 in 
10,000. In Wandsworth the mortality was 111, in St. Olave 183, 
in Bermondsey 194, in 10,000. 

Lambeth Water Company and Southwark iVater Company. — The 
mortality from Cholera was at the rate of 131 in 10,000. In the 
district of Lambeth the mortality was 115, St. Saviour 166, St. 
George, Southwark, 168, Newington 145, Camberwell 102, in 
10,000. 

Southwark and East Kent Water Works Companies. — The mor- 
tality from Cholera was at the rate of 268 in 10,000 inhabitants. 

East London Water Company. — The mortality from Cholera was 
at the rate of 69 in 10,000 inhabitants ; and 49 in Stepney, 95 in 
Bethnal-green. 

New River Water Company. — The mortality from Cholera was 
at the rate of 48 in 10,000 inhabitants ; the mortality was least in 
Clerkenwell (19), near the head reservoir; greatest (96), in West 
London, on the edge of the Thames. 

Arranging the 12 groups of districts in the order of mortality, 
it appears that the mortality from Cholera was lowest, or 10, 17, 
and 23, to 10,000 inhabitants, in districts which have their water 
chiefly from the Thames so high as Hammersmith and Kew. 
Upon the other hand the mortality was highest, or 131, 156, and 
268 to 10,000 inhabitants, in the districts which have their water 
from the Thames so low as Battersea and the Hungerford Bridge. 
The districts of the New River occupy an intermediate station. 

The Registrar-General observes on this subject : 



THE SECOND OUTBREAK. 1849. 101 

" For those unacquainted with the Thames, it is necessary to state, that the 
contents of the greater part of the drains, sinks, and water-closets of 2,200,000 
people, after stagnating in the sewers, are poured daily into its waters, wliich 
spread over more than 2,000 acres in the midst of the inhabited parts, and 
are incessant! j^ agitated by the tides, which ascend to Teddiiigton, and carry 
the matters in the thickest waters below London-bridge, a mile and a half 
above Battersea-bridge, twice a day. The large Chelsea sewers open into 
the Thames above the point at which the water is taken up from the Thames 
by the Southwark and Chelsea Water Companies ; but the suction-pipe of the 
Chelsea Company extends into the centre of the stream. The water, it is said, 
is filtered by all the Thames Water Companies." 

We frequentljr hear it stated that physical and moral disease 
may be produced by one and the same cause ; that the locality of 
fever and pestilence will ever be found to be associated with crime, 
or with vice in its most aggravated forms ; that to improvident 
habits may be traced that poverty and wretchedness which are the 
great causes of disease ; and that the conditions arising from 
these circumstances will furnish an accurate explanation of the 
susceptibility to every species of pestilence. Such views, to be 
worthy of acceptance, should be shown to rest on facts ; if they 
have not this foundation, they will fail to make the desired im- 
pression on those to whom they are specially addressed, and whose 
benefit it is the object to promote. In this respect, how stands it 
with Cholera ? Does the class among whom Cholera has been most 
rife, yield also the greatest number of criminals, help most to fill 
our workhouses, send daily most victims to hospitals, and assist in 
the greatest degree to people our lunatic asylums ? We shall 
examine, in order to test this matter, ten different classes of occu- 
pations, not selected, but taken somewhat indiscriminately, for 
the purpose of investigating a variety of conditions of life. The fol- 
lowing Table shows the rate of deaths from Cholera in London to 
the number living under each occupation ; and also the rate in 
the same class and population of inmates of gaols, and workhouses, 
lunatic asylums, and hospitals, in England. In order to assist the 
reader, we have placed index figures by the side of the numbers in 
each column, showing the ratio in which they stand to one another ; 
for instance, mariners stand first in point of liability to Cholera, 
ninth in respect to crime, seventh as to those causes leading them 
to seek a refuge in workhouses, ninth as to lunacy, and fifth as to 
sickness or accident : 



102 



THE SECOND OUTBREAK 1849. 



Occupation. 
(Males.) 


Rate of 
Deaths by 
Cholera to 
Population. 


Rate of 

Inmates of 

Gaols to the 

Population in 

1841. 


Rate of 

Inmates of 

Workhouses 

toPopulation, 

1841. 


Rate of 
Inmates of 

Lunatic 

Asylums to 

Population, 

1841. 


Rate of 

Inmates of 

Hospitals to 

Population in 

1841. 


Mariners . . . 
Weavers . . . 
Labourers . . . 
Porters .... 
Carpenters . . . 
Shoemakers , . 
Gentlemen . . . 
Tailors .... 
Pensioners . . . 
Clerks .... 


(1) 24 

(2) 36 

(3) 65 

(4) 131 

(5) 155 

(6) 162 

(7) 200 

(8) 244 

(9) 333 
(10) 477 


(9) 1,069 

(2) 168 
(1) 111 

(4) 314 

(7) 632 

(5) 327 
(10)2,691 

(3) 308 

(8) 1,067 

(6) 450 


(7) 834 

(1) 121 

(2) 138 
(6) 406 
(5) 393 

(3) 217 

(4) 246 

(8) 868 


(9) 1,443 

(2) 377 

(3) 779 

(6) 995 
(8) 1,265 

(7) 1,077 

(4) 870 

(5) 971 
(10) 2,669 

(1) 373 


(5) 548 
(4) 509 
(3) 415 
(2) 373 

(7) 1,074 

(8) 1,193 

(6)* 961 
(l") 191 



The above Table would show, among weavers and labourers, a 
great susceptibility to the evils noticed in oui' preliminary remarks ; 
but, generally speaking, it will hardly bear the construction that 
vice and Cholera are necessarily connected ; at the same time, 
however, it presents an interesting view of the physical, economical, 
and moral health of the people, so far as the specified occupations 
are concerned. 

Of 1000 deaths from Cholera, taken from the bills of mortahty 
for three weeks, 280 occurred in men, 331 in women, 209 in boys, 
and 180 in girls. Of the women, 116 were wives, 82 widows, and 
30 spinsters ; and of the others not so classed, 11 were servants, 
8 prisoners, 4 dressmakers, 4 laundresses, 3 ladies, 3 paupers, and 
the other 18 are distributed among 8 occupations. Among the 
men, the highest numbers appertaining to any one class are 
respectively, 41 labourers, 18 mariners, 13 carpenters, 12 shoe- 
makers, 9 tailors, 9 weavers, 7 pensioners, 7 clerks, 6 porters, and 
3 gentlemen; leaving 155 deaths to be apportioned to 95 occu- 
pations, or one-sixth to each. Of the wives, the highest numbers 
are among those whose husbands were labourers and shoemakers 
(31 and 9 respectively) ; and of the children, 39 are sons of 
labourers, and 33 daughters of the same class ; the highest num- 
bers, as it respects children, standing in equal ratios to those of 
the men. We must not, however, draw an absolute conclusion 
from the above premises, and infer that labourers are more subject 
to Cholera than any other class of the population. To arrive at 
accurate results, the proportion of any class to the whole popula- 



THE SECOND OUTBllEAK 1849. 



103 



tion must be taken into account ; and this has been done for 
twenty different occupations, in the ensuing Table. 



Description. 


Number of 

Deaths 
by Cholera. 


Number living of eacli 

description in England 

in 1841. 


Men 

Women 

Boys 

Girls 

FEMALES. 

Servants 

Prisoners 

Dressmakers 

Laundresses 

Paupers 

Ladies 

MALES. 

Labourers 

Mariners 

Carpenters ..... 

Shoemakers 

Tailors 

W^eavers 

Pensioners 

Clerks 

Porters 

Gentlemen 

All Occupations to the T 
20th of October. . J 


in 1,000 
280 
331 
209 
180 

11 
8 
4 
4 
3 
3 

41 
18 
13 
12 

9 
9 
7 
7 
6 
3 

14,538 


3,897,336 
4,223,780 
3,430,181 

3,448,857 

712,493 

9,865 

89,079 

45,019 

69,810 

303,583 

307,535 

288,630 

127,804 

165,881 

96,142 

58,991 

21,349 

47,732 

23,891 

118,412 

7,094,186 



From this it would appear, that occupation exercises little influ- 
ence over the liability to Cholera. But in order to test this point 
still further, we shall take a wider range, and give the following 
statement, constructed by Dr. W. A. Guy, Professor of Forensic 
Medicine, at King's College, and Physician to King's College 
Hospital. It is an abstract of the occupations of 4,312 males, 
fifteen years of age and upwards, who died of Cholera in London 
during the years 1848-9; together with a rough approximation to 
the ratio which the deaths bear to the living. This ratio is ob- 
tained, in the case of tradesmen, by dividing the number following 
each trade (as given in the Post-office Directory for 1840) by the 



104 



THE SECOND OUTBREAK 1849. 



number of deaths; and in the case of all the other classes^ by 
dividing the number of the living in each class, as returned by the 
Census of 1841, by the number of deaths. In the case of such of 
the working class as follow occupations of the same name with 
that borne by tradesmen, the number of the living is obtained by 
subtracting the number of tradesmen from the total given in 
the Census, such total comprising both the employers and the 
employed. The Table comprises the inmates of workhouses, 
hospitals, and asylums, who were returned as having definite oc- 
cupations. 



Gentlemen, and men of in-\ 
dependent means / 

Clergymen of the Church of "j 
England (3), and minis- > 
ters of other persuasions(3) | 

Physicians, Surgeons, and\ 
General Practitioners. . . / 

Magistrates, BarristerSjCon- ) 
veyancers, and Attorneys/ 

Learned Professions . . 

Architects, Civil Engineers, \ 
and Surveyors / 

Actuaries, Accountants, Bill 
and Share brokers, Editors, 
Reporters, &c 

Merchants 

Officers in the Army and Navy 

Other Professions 

TRADESMEN (mASTERS), &C. 

Agents 

Auctioneers 

Bakers ,..,,... 

Blacksmiths, Whitesmiths, \ 
Locksmiths, &c / 

Brewers , , 

Bricklayers and Builders. . . . 

Bookbinders, Booksellers, \ 
Stationers, Printsellers, > 
&c J 

Brokers 

Butchers 

Cab and Omnibus Proprietors 





Ratio. 


135 


1 in 200 


6 


1 in 213 


16 


1 in 265 


13 


1 in 375 


35 


1 in 297 


11 


1 in 115 


14 


1 in 118 


11 


1 in 348 


11 


, , 


8 




12 


1 in 49 


1 


1 in 266 


8 


1 in 133 


2 


1 in 65 


1 


1 in 160 


14 


1 in 39 


14 


1 in 96 


6 


1 in 170 


8 


1 in 123 


5 


., 



Cabinet makers. Carpenters, 
Upholsterers, Under- 
takers, &c 

Cheesemongers 

Chemists and Druggists 

Chimneysweeps 

China, Glass, and Earthen- 
ware Dealers 

Clerks, Accountants, &c 

Coffee-shop keepers 

Coal Merchants 

Corn Chandlers 

Cowkeepers, Dairymen, ~1 
Milkmen / 

Custom-house Officers 

Drapers, Hosiers, Haber- ) 
dashers, &c / 

Dyers 

Eating-house Keepers 

Egg Merchants 

Excise Officers 

Farmers 

Fishmongers 

Foremen 

Fruiterers and Greengrocers. 

Gardeners 

General Dealers 

Grocers 

Hatters and Furriers 

Ironmongers 

Jobmasters, Livery-stable )^ 
Keepers j 

Master Mariners 

Musicians 

Oilmen 

Painters and Glaziers 

Paper makers. . , . , 



so 


Ratio. 


14 


1 in 


100 


13 


1 in 


51 


7 


1 in 


86 


2 


•• 




5 


1 in 


51 


100 






3 


1 in 


85 


6 


1 in 


85 


5 


1 in 


85 


8 


lin 


20 


11 






17 


1 in 


71 


2 


1 in 


112 


3 


lin 


36 


5 


1 in 


6 


7 






8 






n 


1 in 


20 


12 






12 


1 in 


28 


4 






32 






20 


1 in 


65 


3 


1 in 


143 


7 


1 In 


53 


5 


1 in 


37 


25 






4 






13 


1 in 


46 


3 


1 in 


142 


2 


1 in 


15 



THE SECOND OUTBREAK 1849. 



105 



Pastrj'cooks 

Pawnbrokers 

Printers 

Poulterers 

Publicans, Licensed Vie-"^ 
tuallers, Beersellers . . . . j 

Saddler 

Saihnakers 

Salesmen 

Schoolmasters 

Shoemakers 

Tailors 

Travellers 

Tobacconists 

Turners 

"Wharfingers 

Wheelwright 

Wine Merchants 

Other trades 



ARTIZANS AND LABOURERS. 

Artists, Print colourers, &c.. . 

Bakers 

Ballast-heavers 

Bargemen 

Barmen, Potmen, Potboys. .. 

Basket-makers 

Beadles 

Beggars, Tramps, &c 

Bricklayers 

Brickmakers 

Brass-finishers 

Boat-builders 

Bookbinders 

Brushmakers 

Butchers 

Cabinet-makers and Uphol- \ 

sterers J 

Cabmen 

Carmen, Carriers, and Carter- 
Carpenters and Joiners 

Carvers and Gilders 

Chimney- sweeps 

Ditto (Masters and Men) . . 

Cigar-makers 

Coachmen and Cabmen 

Coachmakers 

C oalporters and Coalheavers . . 

Compositors 

Cooks and Confectioners . . . . 

Convicts 

Coopers 

Corkcutters 

Curriers and Leather-dressers 

Cutlers 

Comb-makers 



BX 



2 

4 
4 
3 

42 

1 

2 
7 
7 
8 
6 

19 
6 
2 
2 
1 
5 

34 



52 

7 

18 

8 

7 

5 

6 

47 

12 

3 

3 

18 

11 

32 

70 

35 

52 

111 

9 

7 

9 

4 

57 

16 

53 

21 

11 

36 

28 

2 

24 




1 in 120 
1 in 233 



1 in 
1 in 
1 in 
1 in 



1 in 170 



1 in 148 
1 in 24 
1 in 126 

1 in 96 



1 in 143 
1 in 67 
1 in 318 
1 in 166 
1 in 150 
1 in 153 
1 in 174 

1 in 89 



1 in 74 
1 in 155 
1 in 219 

1 in 109 

1 in 95 
1 in 262 
1 in 32 

1 in 106 

1 in 124 
1 in 279 
1 in 95 
1 in 106 
1 in 148 



Dock-labourers 

Draymen 

Drovers 

Dustmen and Scavengers. . . . 

Dyers 

Engineers 

Engravers 

Farriers 

Firemen 

Fishermen 

Footmen and Man-servants . . 

Founders 

French Polishers 

Furriers 

Gardeners 

Gas-fitters 

Glass-workers, Glass-cut- \ 

ters, &c j 

Glass-blowers . 

Glove-makers 

Grooms and Hostlers 

Gun -makers 

Hairdressers 

Hatters 

Hawkers, &c 

Japanners 

Jewellers, Goldsmiths, and\ 

Silversmiths / 

Labourers 

Lamplighters 

Last-makers 

Letter Carriers and Postmen 

Lightermen 

Lithographers 

Locksmiths and Bellhangers 

Masons 

Matmaker 

Mathematical Instrument \ 

makers / 

Porters, Messengers, and\ 

Errand-boys J 

Milkmen and Cov/keepers . . . 

Modellers 

Musicians 

Millwrights 

Packers 

Painters, Plumbers, and) 

Glaziers J 

Paper makers and Stainers . . 

Plasterers 

Pensioners 

Policemen 

Polishers 

Potters 

Printers (including Com-) 

positors / 



10 

13 
6 
6 
7 

44 
9 

12 
2 
6 

25 

10 
6 
6 

48 
8 



3 
3 

37 
7 
13 
26 
67 
2 

6 

756 
6 
2 
6 

20 
3 
3 

17 
1 



99 

14 
3 
6 
2 
2 

73 



20 

64 

24 

4 

6 

61 



106 



THE SEC(JND OUTBREAK 1849. 



Rag-sorters 

Railway Guards 

Rope-makers, Cord and) 

Twine Spinners, &c j 

Sailors (including Green-) 

wich Pensioners J 

Saddlers, Harness, and) 

Whip-makers / 

Sawyers 

Scalemakers 

Shipwrights 

Silk-dressers 

Shoemakers 

Shopmen 

Smiths 

Soldiers 

Stokers 

Sugar-bakers 

Tailors 

Tanners 

Tallow Chandlers 

Tin-plate Workers 

Tobacco-pipe Makers 

Toll-col] ectors 



=« 












"2 '^ 


Ratio. 


3« 




^ 




2 


1 in 54 


10 




12 


1 in 88 


299 


1 in 24 


15 


1 in 133 


33 


1 in 90 


2 


1 in 60 


20 


1 in 105 


2 




151 


1 in 162 


35 


. , 


62 


1 in 105 


62 




13 




4 


1 in 152 


80 


1 in 244 


22 


1 in 39 


2 


1 in 430 


7 


1 in 178 


6 


1 in 75 


3 


1 in 56 



Toymakers 

Turners 

Type-founders 

Umbrella makers . . . 

Undertakers 

Waiters 

Watchmen 

Watermen 

Ditto (Cabbtands) 

Warehousemen 

Watchmakers 

Weavers 

Wheelwrights 

Window-blind makers 

Wine-coopers 

Wharfingers 

Wire-drawers 

Woolsorters , 

Other occupations. . . , 



Subtract as entered twice , 



•2 =« 



4 

18 
1 
3 
2 

14 
7 

27 
2 
8 

11 
102 
8 
3 
3 
2 
3 
4 

75 



4342 
30 



4312 



1 in 76 
1 in 83 
1 in 390 
1 in 176 
1 in 325 



1 in 61 

1 in 472 
1 in 364 
1 in 36 
1 in 294 
1 in 82 
1 in 171 
1 in 85 
I in 61 



No attempt is made to correct for increase or decrease of population since 1841 ; and 
the persons of the several occupations returned in the metropolis by the Census 
Commissioners do not include those of Wandsworth, Hampstead, or Lewisliam. 

To assist the reader in tracing the course of the epidemic in 
respect to season, we subjoin the following diagram, which exhibits 
at one view the course of the Cholera from October 14th, 1848, to 
October 13th, 1849, compared with the Plague of 1665, and the 
deaths fi-om all causes (Cholera excepted) for the same period 
together with the indications of the theraiometer and barometer. 
This presents very many points of interest, not the least of which 
is the remarkable coincidence between the course of the Cholera 
and that of the Plague, excepting only as to virulence. In this 
chart, the thin line is meant to represent the course of the Cholera ; 
the thick line that of the Plague ; the double line the deaths from 
all causes ; the thin-dotted line the readings of the barometer j and 
the thick-dotted line those of the thermometer. 

This table is copied from the Medical Times of November 3rd, 
1849, and forms part of a valuable communication by Mr. B. 
Smith, to which the reader is further referred. 







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THE SECOND OUTBREAK— 1849. 



107 



Cholera appears to be more fatal to females than to males. Of 
14,497 deaths from Cholera, there are 6,914 males, and 7,583 
females, — giving a majority of the latter by 669 ; and reversing the 
law which generally holds in respect to other diseases. But when 
we consider the conditions of age and sex together, fm-ther pecu- 
liarities appear. Of the total number of persons cut off by 
Cholera, 4,447 die from to 15 years of age; 8,629 from 15 
to 65 ; and 421 from 65 and upwards. This appears to be a 
deviation from the law regulating the mortality of zymotic diseases 
generally ; according to which a majority of deaths occur from 
to 15 ; but the same deviation is observed as to this disease in 
all countries and in all climes. To specify more particularly, 
however, the following table gives the various ages relatively to 
sex, and the population of various ages in Middlesex, to every 
10,000 persons living. (The population given is that at the 
periods from to 20, and from 20 years of age and upwards.) 



Age. 


"^Male!- Population. 


Deaths. 
Female. 


Population. 


Total 
Deaths. 


Population. 





1,103 




934 




2,037 




5 

10 
15 
25 
35 


703 
381 
726 ! 
990 
949 " 


■ 363,430 


633 

317 

650 

1,110 

1,230 


- 385,025 


1,336 
698 
1,376 
2,100 
2,179 


- 748,455 


45 
55 


891 
650 




993 
834 




1,884 
1,484 




65 

75 


384 
120 


Ul3,526 


598 
252 


Ull,695 


982 
372 


V 1,125,221 


1 85 


9 




26 




35 




1 95 

1 ? 


""s 


J 


* 6 


^ 


14 


J 



According to this table, the periods of liability seem to be, as to 
age for both sexes, at 0, 25, 35, 45 ; and, as respects females, 55 ; 
and the ages of 10, 75, and 85, the least liable; as it respects 
males, the deaths are above those of females, at the ages of 0, 5, 
10, and 15 ; from which latter period the deaths of females invari- 
ably preponderate, with the differences respectively of 120, 281, 
102, 184, 214, 132, and 17. By the deaths, at each age, however, 
according to population, the following appears to be the result : 



108 



THE SECOND OUTBREAK 1849. 



1 Male 

1 „ 

1 Female 

1 „ 

1 of both sexes 

1 



dies ill 106 6 uiidtr 20 3 eais of age. 



in 146-8 above 20 
in 124-6 under 20 
in 136-3 above 20 
in 115-6 under 20 
in 140-9 above 20 



and upwards. 



And hence the ratios of liabiHty would be, first, males under 
20 years of age; second, both sexes, under 20; thnd, females 
under 20 ; fc^rth, females above 20 and upwards ; fifth, both sexes 
above 20 and upwards ; and sixth, males above 20 and upwards. 

As to the duration of the disease, it appears that of all the 
deaths, 212 took place within one hour from the period of attack; 
6,651 under one day, 2,461 in one day, 1,045 in two days, 306 in 
seven days, and 7 in twenty-eight days. In respect to sex, the 
duration of attack was as follows : 



Period. 


Males. 


Females. 


Total. 


hour 


136 


76 


212 


6 „ 


950 


809 


1,758 


12 „ 


1,575 


1,661 


3,236 


18 „ 
Total under 1 day 


636 


809 


1,445 


3,297 


3,354 


6,651 


1 day 


1,109 


1,352 


2,461 


2 „ 


486 


559 


1,045 


3 „ 


386 


438 


824 


4 „ 


244 


269 


513 


5 „ 


207 


195 


402 


6 „ 


104 


118 


222 


7 „ 


139 


167 


306 


8 ,y 


45 


65 


110 


9 „ 


30 


39 


69 


10 „ 


72 


106 


178 


14 „ 


43 


70 


113 


21 „ 


12 


21 


33 


28 „ 


4 


3 


7 


9 


736 


827 


1,563 



It has been shown that there was a remarkable coincidence 
in the course of Cholera in 1848-9, and the plague; and not 
only this, " for," says Mr. Smith, " during the four plagues of 
1603, 1625, and 1665, as compared wath the Cholera, the same 
phenomenon appears." The following is the Table subjoined : — 
{Medical Times ; ibid.) 



THE SECOND OUTBREAK 1849. 



109 



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110 THE SECOND OUTBREAK 1849, 

The author of the above remarks, that " Much has been said as 
to the dependence to be placed on the records of the plague, and 
the correctness of the old bills of mortality ; but from a glance at 
them, as here given, they seem to bear internal evidence of an 
approximation to the truth." And Heberden says : — " The agree- 
ment of these bills with each other does alone carry with it a 
strong proof that the numbers under the several articles are by no 
means set down at random; and that such registers, taken 
together, and considered on an extensive scale, must be allowed to 
constitute a very unexceptionable basis for medical reasoning." 

A veiy prevalent notion is here worth alluding to. It has fre- 
quently been said, that while any pestilence is raging, other 
diseases (and especially those of the zymotic class), are found 
partially to disappear. The following Table, as given by the 
authority mentioned above, — Mr. Smith, from whose labours we 
have so largely drawn, and the value of which we here acknow- 
ledge, — will show how far this idea is borne out by the facts : 



THE SECOND OUTBREAK 1849. 



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112 THE SECOND OUTBREAK 1849. 

The result to be deduced from this Table is as follows : — 

1840 1841 1842 1843 1844 1845 1846 1847 1848 1849 
Cholera .... 61 41 120 80 66 32 221 104 273 13,554 
Typhus . . „ . 695 366 652 1,235 977 662 530 1,734 1,974 1,385 
All Zymotic"] 

Diseases ex- 12,772 2,298 2,644 5,670 3,904 4,865 5,393 7,264 9,816 8,669 
cept Cholera J 

or. Deduct Diarrhoea beyond "1 , ^^^ 
the average ot five years. . . J ' 

6.890 

Thus, the average of deaths from typhus being, for the two 
years, 1,021, the deaths in 1849 were over the average by 364, 
but under those in the years 1847 and 1848 by 349 and 589 
respectively. The average of deaths from all zymotic diseases, 
excepting Cholera, being, in the ten years, 5,151, the deaths in 
1849 were 1,739 above that average, but under the average, in 
1847 and 1848, by 374 and 2,926 respectively. Hence the 
assumption would appear to be groundless, that other diseases are 
in abeyance while the Cholera is prevalent ; for though 1849 does 
show a decrease both as to typhus and all zymotic diseases, as 
compared with 1847 and 1848,, and that, notwithstandhig increase 
of population, yet there is not so much difference but that it may 
be accounted for by the fact of the Cholera taking off a great num- 
ber who would otherwise have been subjected to other zymotic 
diseases. The vast increase of deaths, however, from typhus and 
other zymotic diseases, in the two years previously to the ravages 
of Cholera, is particularly worthy of attention. 

Such were among the leading phenomena attending the course 
of an epidemic disease which, in its virulence in the metropolis of 
England, has had no parallel in modern times. In considering 
its primary causes, the scientific world have been baffled ; and for 
this reason, perhaps, the religious world have stamped it as a dis- 
pensation of Providence, inexplicable on the principles of human 
philosophy; while others, too glad to rid themselves of any 
responsibility in the matter, have readily fallen in with the latter 
notion, and have vied with the religious professor in declaiming 
against the temerity of all theorizers. But more than this. They 
have evaded the question, also, as to secondary causes; and, as 



THE SECOND OUTBREAK 1849. 113 

if they were peculiarly jealous that the benehcent Author of life 
should monopolize the credit of all fever and pestilence to himself, 
they have stood forth, in the midst of fetid swamps and reeking 
charnel-houses, denying that putrescence and corruption are inimi- 
cal to health. It is not long since the editor of a religious journal 
expressed the opinion, that graveyards in the midst of a crowded 
city might rather be considered a boon, since they left an open 
space, whence pure air might be received by the inhabitants of the 
adjoining buildings. Oh, then, that we had more graveyards, or 
less of professedly religious patriotism ! Now this course of pro- 
cedure is, we think, sufficient reason, in concluding this inquiry, for 
drawing the attention of our readers to the subject of intra-mural 
buiials. How far their connection with Cholera is to be traced, may 
safely be left to the judgment of the public. It appears to be 
decided, that placing a dead body in a grave, and covering it with 
a few feet of earth, do not prevent the gases generated by decom- 
position, together with the putrescent matter which they hold in 
suspension, from permeating the surrounding soil, and escaping 
into the air above and the water beneath. This escape takes 
place with so much force, that the gas often bursts even a leaden 
coffin ; and though a part is generally absorbed by the soil, yet 
much is diffused in every direction, but chiefly upwards. Mr. 
Leigh, a chemist at Manchester, says : — " If bodies were interred 
eight or ten feet deep in sandy or gravelly soils, I am convinced 
little would be gained by it ; the gases would find a ready exit 
from almost any practicable depth." And Dr. Playfair estimates 
that the amount of the gases evolved annually from the decom- 
position of 1,117 corpses per acre, which is far short of the num- 
ber actually interred in the metropolitan graveyards, is not less 
than 55,361 cubic feet. Now, as 52,000 interments take place an- 
nually in the metropolis, according to this ratio, the amount of 
gases emitted is equal to 2,572,580 cubic feet; the whole of 
which, beyond what is absorbed by the soil, must pass into the 
water below, or the atmosphere above. When we consider that 
decaying or putrescent matter is capable of communicating its 
qualities to other matters, causing them to exhibit the same con- 
ditions, we may estimate the result of a whole population of a 
crowded metropolis inhaling the gases here evolved. And what, 
then, are likely to be the results when, " in the metropolis, on 



114 THE SECOND OUTBREAK 1819. 

spaces of ground not exceeding in all 218 acres^ closely sur- 
rounded by the abodes of the living, crowded together in dense 
masses, upwards of 50,000 dead bodies are buried every year V 

It appears, indeed, that Cholera was unusually prevalent in the 
immediate neighbourhood of these burial-grounds, and Dr. Suther- 
land makes the same obseiTation. He says : 

" I witnessed several outbreaks of Cholera in the vicinity of graveyards, 
which left no doubt on my own mind as to the connection between the 
disease itself and such local influences. Two instances occurred at Bristol, 
the particulars of which I reported at the time to the General Board of Health. 
The results in both were most disastrous. Long-continued contact with the 
morbific influences proceeding from graveyards and other nuisances appeared 
to have produced such a degree of susceptibility, that, as soon as the epidemic 
touched the locality, the people fell before it. There is evidence to prove 
that a large fatality took place also during the last Cholera epidemic in the 
neighbourhoods immediately adjoining the graveyards of the metropolis. It 
is not always easy to separate the effect of each specific cause of disease 
where a number co-operate, but after a most extensive experience the evi- 
dence which has come before me has produced on my own mind an abiding 
conviction, that the effects of many causes of unhealthiness, and that of 
churchyards amongst others, has been very much underrated. I have no 
doubt whatever that the burial-grounds, as at present constituted, are a con- 
tinual source of pestilence ; slow, perhaps, in its operation, and hence over- 
looked by ordinary observers. They are undermining the constitutional 
stamina of thousands of our town populations, while people are denying that 
they have an injurious tendency; and it is only when some epidemic comes 
to try it like a touchstone, that the consequence of long antecedent neglect 
becomes so apparent as to rivet attention and excite alarm." 

Now, it appears that in Bethnal-green bm-ial-ground alone, con- 
sisting of an area of about two acres and a half, there have been in- 
terred, since its opening in the year 1746, upwards of 56,000 dead 
bodies. In Bunhill-fields burying-ground. City-road, consisting of an 
area of less than four acres, there have been interred, from April 
1713 to August 1832, according to the registry, which, however, in 
early years, was very imperfectly kept, 107,416 dead bodies. But 
in St. Pancras churchyard, one-half of which has been used as a 
burial-place for at least six centuries, there have been deposited 
the remains of more than twenty generations ; and in this space of 
ground, which does not even now exceed four acres, and a large por- 
tion of which was considered as full to excess twenty years ago, there 
have been interred, since that period, upwards of 26,000 bodies. 

Estimating the d»u-ation of a generation at thirty years, there 



THE SECOND OUTBREAK 1849. 115 

must have been interred, in the small space of 218 acres, in the 
last generation, a million and a half of dead bodies, and within 
the next thirty years more than another million and a half of the 
dead; that is, a large proportion of those who now people the 
metropolis will have to be crowded into those same churchyards, 
unless other and better provision for interment be made. But not 
to depend on the bare statement of figures^ the force of which can 
hardly be felt, what was the actual condition of the burial-grounds 
in 1849, when the Cholera was raging ? The following is a brief 
analysis of the state of the case, as reported to the General Board 
of Health by Dr. Mih'oy and others : 

" St. Ann's, Blackfriars. — Very limited dimensions ; completely hemmed 
in on all sides by buildings ; ground so entirely occupied that it is only by 
boring that the gravedigger can find out where a new grave can be opened. 
Some of the inmates of the houses overlooking the pauper part of the burial- 
ground state that they have seen skulls, with portions of the scalp and hair 
adhering to them, thrown out from a newly-made grave. Most of the occu- 
pants of the dwellings surrounding the churchyard complain much of offensive 
exhalations from it, more especially for the last two or three months ; and 
during this time Cholera has been very prevalent among them." 

" Lock Burial-ground, Dover-road, Southwark, belonging to St. George 
the Martyr. — The very appearance of its surface indicates that it is surcharged 
with human remains ; yet within the last nine or ten weeks no fewer than 
240 bodies have been deposited in it. I was informed by an eye-witness 
that sixteen coflSns were recently put into one grave, one immediately after 
the other, that is, in the course of one hour. This was in the month of 
August, during the height of the epidemic. There is sometimes not more 
than eight or ten inches of eartli between the coffin and the surface. Funeral 
service being performed only three days in the week, corpses are detained 
until the regular time of burial comes round. They are often left unburied 
all night, lying on the open ground." 

" St. George-the-Martyr, Southwark. — It is closely surrounded by 
dwellings, chiefly of the lower sort, on three sides, and on the ether side by 
the east end of the church. Several of the residents in the houses overlooking 
the churchyard complain of offensive effluvia from it, especially after rain. 
Three fatal cases of Cholera have recently occurred in these dwellings." 

" Burial-ground, Parker-row, Dockhead, — The depth to which a grave 
can be dug here does not exceed five or six feet; and yet in such a grave 
two and three coffins are sometimes placed. There must consequently be not 
more than a foot or two of earth, at most, between the top coffin and the 
surface. The residents in most of the houses in Parker-row, which faces the 
front ground (the least crowded of the two), complain very much of the 
exceedingly offensive effluvia from it, more especially early in the morning, 
-and in warm foggy weather. There has been a great deal of sickness among 

I 2 



116 THE SECOND OL'TBREAK 1849. 

the inhabitants during the last three months, and several deaths from Cholera 
took place some weeks ago." 

" ToTTENHAiM-couRT-ROAD Chapel Borial-ground. — One of the managers 
of the chapel informed me that the average number of interments, in the 
course of a year, has been of late between 400 and 500 ; but there appears 
reason to suppose that it is considerably higher. Since the beginning of 
July to the present date, September 7th, 1849, 134 burials have taken 
place. The gravedigger admits to seven or eight coffins of adults, and to 
between twenty and thirty coffins of cliildren, being deposited in one grave, 
the grave being only partially closed until the last coffin be put in. Many of 
the inmates of tenements overlooking the north division of this graveyard 
testify to putrid effluvia emanating from it, especially when hot weather 
follows rain." 

"New Bunhill-fields, Golden-lane, St. Luke's. — This graveyard is 
neai-ly surrounded on all sides by dwellings; but there is a high wall, of from 
twenty to twenty-four feet in height, intervening all round. Mr. Smith, 
surgeon, of 154, Whitecross-street, and one of the recently appointed medical 
officers, informs me that the neighbourhood of this burial-ground is always 
infested with fever; and that in the adjoining courts, within 200 )'ards of 
it, some most malignant and rapidly fatal cases of Cholera have recently 
occurred." 

"St. George, Hanover-square, Uxbridge-road. — The sexton admits 
it is only by bormg that a spot for a grave can be found. Of course, no 
-exact register of the precise localities where interments have already taken 
place has been kept. The average number of interments for several years 
prior to 1848 was rather more than 1,000 per annum. Last year, 1848, the 
number rose to 1,183 in all ; and since the 1st of July of the present year to 
this date, September 18th, 358 have been been buried in the ground. Upon 
making inquiries of the residents in a number of the houses that overlook this 
burial-ground, I found that they very generally complained of offensive 
effluvia perceived at certain times, and usually most after rain followed by 
hot weather. The medical attendants of several of those families have recom- 
mended them to leave their dwellings in consequence." 

" St. Mary's, Nlwington, Surrey. — Many of the residents in the imme- 
diate neighbourhood complain of foul effluvia proceeding from this biu-ial- 
ground ; so much so, that at times they have been obliged to shut their win- 
dows. The nuisance has been greater of late; nor can this be wondered at, 
when it is known that no fewer than 436 bodies have been interred there 
during the last nine or ten weeks." 

" New Bunhill-fields Cemetery, Deverell-street, New Kent-road. 
— Surrounded on three sides by dwellings. Besides the grave-yard, an 
immense niunber of burials has been made in the vaults under the chapel in 
the ground. The number of coffins piled up one above another has probably 
exceeded a thousand. On the south side of the chapel there is a spot where 
there is a vast accumulation of bones close to the surface. Several of the 
residents in Theobald' s-street and Deverell-street, which run along the east 



THE SECOND OUTBREAK 1849. 117 

and west sides of the grave-j'ard, state that they have experienced offensive 
effluvia from the burial-ground, and several deaths from Cholera have taken 
place in both these streets." 

" St. Olave and St. John, TootEY-sTREET. — Extent very little more than 
half an acre : has been used for the purposes of interment since the time of 
Queen Elizabeth. During the present year no fewer than 386 burials have 
already taken place; of these 196 have been within the last twelve weeks. 
The grave-j'ard is open to Tooley-street on the south side ; on the other three 
sides it is inclosed by buildings. As may be supposed, the ground is exceed- 
ingly full of human remains. Mr. Wright, one of the churchwardens of St, 
Olave, states that one of the gravediggers acknowledged to him that he had 
occasionally displaced one coffin, in order to make room for a deep grave at 
its side. The Rev. Mr. Le Breton, Curate of St. Olave 's, states that on one 
or two occasions he has been much annoyed, and that, in consequence, he 
always makes a point of standing on the windward side of a grave. Several 
of the residents in Potter's-fields complain of foul smells from it, especially of 
iate, when many of the burials took place near to their houses; and Mr. 
Viner, surgeon, of 114, Tooley-street, mentioned to me that one of the grave- 
diggers (Kennedy by name,) whose family he attends professionally, has 
more than once admitted to him that the stench from a grave, even within a 
foot or two of the surface, has sometimes occasioned headach and vertigo; 
also, that he was continually exposing coffins when digging to any depth." 

" St. George's Lutheran Church, Whitechapel. — I am informed, by 
good authority, that to such a degree was this small grave -yard crowded with 
corpses thirty years ago, that even then it was deemed requisite by the 
Incumbent of the church that it should be closed. * So far, however, from 
this being done,' my informant goes on to state, 'it is a fact, that since that 
time more bodies have been interred there annually than before.' Several of 
the inmates in the houses overlooking this grave-yard complain of most 
offensive smells from it, especially in hot weather, and whenever the ground 
has been opened for interment. In one instance, the physician insisted upon 
the removal of the family from their residence." 

"St. Botolph's Churchyard, Aldgate. — "It is closely hemmed in on 
the east by houses. It has been long notorious that this churchyard is exceed- 
ingly full of human remains, and that it ought to have been entirely closed 
many years ago. A shocking catastrophe occurred here in 1841, when two 
men lost their lives in a grave from the poisonous exhalations issuing into it 
from the mass of festering corruption at the side. I should mention that the 
floor of the vaults has been much used as a common grave-yard, graves being 
dug there as in the open ground, and ordinary wooden coffins deposited in 
them, up to within a foot or two of the surface." 

" St. Olave, Silver- street. Falcon-square. — The churchyard is of very 
small dimensions, and it is closely hemmed in on three sides by houses and 
other buildings. It is very old ground, having been used for interments since, 
and indeed before the great fire of London. The residents in the houses 
which directly ovei'look the churchyard concur in stating that they have oflen. 



118 THE SECOND OUTBREAK — 1849. 

experienced the most foul and offensive effluvia from it, especially after damp 
hot weather, or when a grave has been dug," 

"Tavistock Burial-ground, Drury-lane. — Has been long knoAvn to be 
entirely occupied in every part with human remains. Fourteen years ago it 
was closed, in consequence of its over-crowded and very offensive state ; but 
it was again opened two or three years afterwards, and it has continued to 
be used ever since. The number of interments that have taken place here for 
the three years ending 3Ist of December, 1848, amounts to upwards of 500 ; 
and already in the present year 127 bodies have been added to this over- 
charged mass of corruption." 

" Spa-fields Burial-ground.— Five-sixths at least of this grave-yard was 
closed against interments four years ago, by order of the Queen's Bench, in 
consequence of the over-crowded state of the ground, and the complaints of 
the inhabitants of the neighboiu'hood. Since that period an additional portion 
of the ground, which appears to have been formerly occupied as a garden to 
the house of the sexton, has been taken in for the purpose of interments : but 
the greater part of this also is, by his own acknowledgment, quite full. In 
the course of last year (1848) 500 burials took place; and already, since the 
beginning of July last to the present date, September 8, 1849, no fewer than 
176 have occvu-red. This burial-ground is surrounded on all sides by dwell- 
ings ; it is constantly complained of by the residents in these houses ; the 
locality is notorious for fever, and several fatal cases of Cholera have occurred 
there within the last few days." 

" St. Giles's -in-the-Fields. — In order to get rid of the bones ; it has been 
the practice in this grave-yard to dig a wide and very deep pit, into which they 
are cast until it becomes nearly full : it is then covered over with sod, and 
another pit is made to receive a like accumulation. This fact alone suffices to 
show how saturated the ground must have been, over and over again, with 
human remains : nor can we be surprised at this, considering that this 
churchyard is one of the very oldest in London, having originally been used 
as a burial-place for the lepers in London." 

" St. Giles's Cemetery, Old St. Pancras-road. — On the 19th of Oc- 
tober, a memorial was addressed to the General Board respecting this burial- 
ground, by Mr, Alexander Marshall, 49, Broad- street, Bloomsbury. In this 
memorial occurs the following statement : — 

" The groinid is only about four acres ; about two acres are occupied by 
private family graves, one acre of which is called maiden, or unused ground. 
The remaining acre is crowded to a shameful and very dangerous degree. 
Practices of a most revolting nature are constantly used. Deep pits are left 
open until filled up within two or three inches of the surface. The bodies 
are placed one upon the other, without a particle of earth between them; and 
I have seen the most offensive greenish discharge running from the bodies. 

" Upon questioning the gravedigger, who has been in office for the last 
eleven years," says Dr. Milroy, " I learned the following particulars as to the 
manner in which pauper interments take place in this groimd. A pit, or 
what is called a ' double grave,' is always dug, and is kept open (boards only 



THE SECOND OUTBREAK 18-19. 119 

being laid over the mouth), until it is filled with the due number of coffins, 
and then it is closed up with earth. A grave of this sort will hold, if it be 
fourteen feet deep, about eighteen adult coffins, and of course many more 
of children. The next grave is opened close alongside of the one just filled 
up, with no space of earth left between ; consequently, the pile of coffins in 
the latter one is very generally exposed in the act of digging the new grave. 
This is what is technically called 'working the ground very close.' Upon 
asking the gravedigger if he always dug down until he came to the coffin 
last deposited, he answered, ' Yes, in order to make as much of the ground 
as possible.' I wrote to Mr. Robinson, the surgeon of the St. Pancras 
Infirmary, to learn if the inmates of the houses had ever perceived foul 
effluvia from the burial-ground. His reply was as follows : — ' It will suffice 
to state, that in all of them complaints have occasionally been made of 
unpleasant effluvia, more particularly in that portion which was originally 
applied to the men's infirmary. Its basement story, however, during the past 
summer has been empty, and only during the last three weeks, owing to the 
crowded state of the female infirmary, has been temporarily occupied. On 
Friday Aveek last (26th October, 1849), some of the inmates complained 
dreadfidly of the odour from the burial-ground, and saw the gravediggers 
removing the coffins from their graves. From that period to Thursday last 
(1st November, 1849), the smell was so offensive that I was compelled to 
remove the parties altogether from the building.' " 

"Christ-Church, Broadway, Westminster. — From all accounts it appears 
that it has been full to repletion for a great length of time, and the general 
surprise is, how room can still be found for the continual additions of coffins 
that are put into it. The Rev. Mr. James, who has been curate of St. Mar- 
garet's, Westminster, for the last eighteen years, says he has repeatedly 
experienced the most disgusting smells from the open graves, and he invari- 
ably makes a point of standing on their windward side to avoid as much as 
possible the foul exhalations. He has seen as many as eight coffins exposed 
in one grave ; and when I mentioned to him that a person had informed me 
that he had on one occasion witnessed no fewer than sixteen coffins so 
exposed, viz., four on each side and four at each end of the grave, Mr. 
James assured me that he could quite believe the statement. The testimony 
of the Rev. Mr. Cook, the other curate, was in accordance with that of Mr. 
James, and both gentlemen mentioned that the Rector of the parish, the Rev. 
Mr, Milman, had expressed his opinion publicly to the same effect, viz , that 
the ground should have been closed long before. The sexton stated that, 
when he entered upon his office three years ago, the churchwardens told him 
that the ground then was quite full, and that they must endeavour to find 
another place for burials. Yet ever since that time no fewer than 600 bodies 
have been annually interred in it, even although a very considerable portion 
of its area — nearly one quarter I believe — has for the last two years been 
entirely unused for sepulture, having been given up for the purpose of being 
taken into the new line of street now forming in Westminster. Of late the 
burials have been more numerous than ever. Nearly 140 have taken place 



120 THE SECOND OUTBREAK 1849. 

/ 

during the last four weeks ; and the large majority of these have been made 

in a very small space of the ground, probably not exceeding forty or fifty 
feet square." 

"St. Clement Danes, Portugal-street. — From the concurrent testimony 
of the occupants of all the houses which overlook the ground, it appears to 
me undeniable that, for some years past, there have been perceived 
occasionally exhalations of mephitic effluvia, especially when the wind set in 
particular directions, or when the weather was close and warm before rain. 
They were always observed to be most offensive whenever the ground had 
been opened. The inmates of King's College Hospital, in Carey-street, and 
of the houses in Portugal-street and St. Clement's-lane, have often been 
obliged to shut their windows to keep out the intolerable stench that sets in 
upon them. Mr. Smith, house-surgeon of the hospital, states that he has 
frequently of late had attacks of nausea and vertigo, which he attributes to 
the effluvia from the graveyard. The same effects have been experienced by 
many of the patients in the hospital, and also of the residents in the houses 
in St. Clement's-lane. The case of the latter persons is especially deserving 
of attention; several of them have but one room for their dwelling, and the 
window of that room, looking out upon the burial-ground, sometimes cannot 
be opened for an entire day, in consequence of the horrible effluvia with 
■which the atmosphere is charged. A very intelligent and respectable woman 
living in Portugal-street, informed me that she had been obliged to change 
her bed-room and the nursery of her children from the back to the front of 
the house, to escape the fcetid exhalations. She particularly specified one 
occasion on which they were more than usually disgusting, and she had made 
a short memorandum of it at the time. The facts were these : — A grave 
was opened on the 29th of June last (1849), and a body interred therein; 
another body was put into the same grave on the 1st of July, a third on the 
8th, and a fourth on the 15th. I should have mentioned that the back wall of 
a labouring man's dwelling, on the ground-floor of No. 85, Clement's-lane, 
forms part of the boundary of the burial ground on the west side. A few years 
ago there was a window in this wall looking out upon the ground, but, in con- 
sequence of the gradual elevation of the soil, from the constantly-increasing 
accumulation of coffin upon coffin, he was obliged to brick up the window and 
make a skylight to the room, the floor of which is now about six feet below 
the surface of the graveyard. The wall distinctly bulges in from the pressure 
of the incumbent earth. About six months ago it began to crack in several 
places ; a small portion of the brickwork gave way, and earth containing 
some fragments of human bones fell in. Offensive as the exhalations from 
this burial ground have been on various former occasions, it would seem, 
from the unanimous testimony of all the witnesses I questioned, that never 
were they so horribly disgvtsting as on Tuesday last, 28th August, when a 
very deep grave had been dug, about the centre (I believe) of the ground. A 
large quantity of bones was exhumed; Mr, Smith ascertained, by a careful in- 
spection of them, that the remains of at least ten different skeletons were thrown 
up. One or two of the skulls presented the appearance of comparatively 



THE SECOND OUTBREAK 1849. 131 

recent interment, all the teeth being entire, and the bones exhibiting the 
aspect of still retaining a portion of their gelatine. The fcetor vipon this 
occasion was so overpowering, that even the beadle of the parish acknow- 
ledged that it was very bad. Not a window facing the graveyard could be 
opened, notwithstanding the oppressive heat of the day. Some of the resi- 
dents were obliged to leave their houses for a time ; persons passing along 
Portugal-street held their nostrils ; a policeman standing at the door of King's 
College Hospital was seized with vomiting ; and one of the physicians of this 
institution, who approached the open grave, was suddenly seized with giddi- 
ness, and would have fallen down if he had not been supported by another 
gentleman. Although the ground in this graveyard thus appears to be so 
saturated with corruption that it cannot be moved without giving forth perni- 
cious emanations, I was informed by the beadle that three or four burials at 
least take place there every week." 

" Burial- Grounds of St. Bartholomew the Great. — These burial- 
grounds are four in number, situated on the west, the south, the north, and 
the north-east sides of the church, to which they immediately adjoin. They 
are closely hemmed in by dwellings, and, taken all together, they are among 
the very worst of the many bad graveyards in the city. 

"1. The west or front ground is the chief one. It is considerably larger 
than the other three, although it does not contain above 500 square yards of 
superficial area. It is inclosed on two sides by the rears of the houses in 
Cloth-fair. Some of these houses have the privilege of having a door lead- 
ing directly into the graveyard ; but it is not very obvious for what purpose 
this privilege was granted, except tliat the residents might be able to use it 
as a substitute for a back yard, where they might deposit any spare lumber. 
I was informed that a small sum has been paid for the benefit of this privilege. 
Another person stated to me that some of the owners of the houses had been 
permitted for a ' consideration ' to encroach upon the bui'ial-ground. In one 
corner there were standing some old dilapidated furniture, an empty tar- 
barrel, and a quantity of rusty iron utensils. The surface of the ground I 
found to be strewed with fragments of human bones, intermingled with fish 
and fowl bones that had been thrown out of the windows, dead rats, and other 
refuse. The inhabitants in the over-looking houses are apt, the sexton said, 
to empty their basins out upon the ground, when there is no one there to 
prevent them. 

"Graves are occasionally dug close up to the very walls and windows of 
the houses ; and the effluvia from the ground when opened are declared to be 
often most offensive. The graves have sometimes been so shallow that not 
above eighteen inches, or a couple of feet at most, have been left between 
the top of the coffin and the ordinary surface of the ground. 

"2. The second, or green ground, is situated on the south side of the 
church. It is not above a third of the size of the former one, and is alto- 
gether in a still worse and more discreditable condition. It looks indeed 
much more like a dust and rubbish yard than a place for the interment of 
human beiugs. In one corner stood a large heap of ashes at the side of a 



122 THE SECOND OUTBREAK 18i9. 

privy; in another there was a quantity of old bricks and mortar; in a third 
there was an unclosed grave, which, although it had already received five or 
six coffins, was only covered over with a few boards, and some handfuls of 
earth strewed upon them, and was therefore ready to receive more coffins 
before being entirely shut; while in the remaining corner, over a compai-a- 
tively recent grave, was to be seen a neatly-kept little mound carefully 
hooped over to keep the earth together, and presenting a sad and painful 
spectacle, by the very contrast of it decency to the grossly neglected state of 
the rest of this ground. 

" 3. But of all the graveyards the north one is immeasurably the worst in 
every respect. A person can scarcely believe that it could ever have been 
used as a place of sepulture. It forms a long narrow strip, not above ten or 
twelve feet in width, between the walls of the church on one side, and the 
rears of some old dirty houses in Cloth-fair, which in some parts overhang 
the ground, on the other. To a stranger it has all the appearance of a filthy 
back yard common to several low and filthy houses. The surface is strewed with 
cabbage-leaves, parings of turnips, fish-bones, and other sorts of rubbish, 
with large splashes of filthy water that had been recently emptied from some 
adjacent window. There is a large pile of hen-coops at one end, and a couple 
of dog-kennels at another part. Upon inquiring to whom they belonged, the 
schoolmaster of the parochial schools informed me that they were his pro- 
perty, adding that the management of the ground had been left by the 
churchwardens in his hands for the last three or four years, and that he made 
use of it as a convenient place to keep his fowls in. At the present season of 
the year, he said, it did not look nice ; but in summer the grass grew quite 
beautifully ! Before his time, the graveyard, he told me, was in a horrible 
state, and not fit to be entered by any one, being ankle-deep in many places 
with excrement which had been thrown out from the houses in Cloth-fair, and 
no better than a common dung-yard. Yet then, or at least not very long 
before, it was the pauper burial-ground for the parish ; and that multitudes of 
human corpses have been thrust into it is sufficiently evident from the great 
rising of the ground, by many feet, above the level of the adjacent court. It 
must indeed have been a shocking spectacle to have witnessed the mockery 
of a Christian funeral here. No one would bury a favourite dog in such a 
spot. I have not seen anything called a graveyard so thoroughly disgust- 
ing and so revolting to every sentiment of common decency, not to mention 
religion, as this ground ; nor did I ever leave a place where I knew that my 
fellow-creatures had been laid with feelings of such indignant regret." 

"Burial-ground, Wade-street, All Saints, Poplar. — The officiating 
clergyman, the Rev. James Hearsnep, admitted that foul smells were per- 
ceptible from the open graves; but stated that, in his opinion, the smells 
were attributable not so much to the decomposition of the bodies that were 
therein deposited, as to the escape underneath the intervening wall of the 
contents of the 2^rivies of those houses into the (/raves. He himself had 
good reason to suspect that this had been the case on more than one 
occasion." 



THE SECOND OUTBREAK 1849. 133 

" Burial-ground of St. James' Chapel, Hampstead-road. — Is between 
three and fonr acres in extent; has been used as a place of sepulture for the 
last sixty years ; is enclosed on three sides by dwellings ; the average num- 
ber of burials has, for many years, exceeded 700 per annum — previously it 
was still greater, amounting to nearly 1000. In the present year the number 
up to the 30th of September has been 693, of which more than one half (364) 
took place in the course of the last three months. As many as six bodies 
have been deposited in a grave of ten or eleven feet in depth. In one corner 
of the ground there have been interred, within the last three or four years, 
nearly 400 bodies, packed as close as the coffins can be made to lie ; and 
within the present year graves have hegun to be dug under the foundation of the 
south wall, so that the contents of the privies in the houses in Little George 
street have been hiown to find their way into them.''^ 

Mr. Ranger again reports : 

"New Bunhill-fields Cemetery, Church-street, Islington. — From 
the best information I could obtain, the ground (which is private property) 
has been in use for sepulture about forty years : it is surrounded on all sides 
by dwellings. One witness states, that such has been the nearness to the sur- 
face at which bodies have been laid, that he has kicked against the coffins 
whilst walking, and, upon complaining of the circumstance to the proprietors, 
they have ordered the digger to mound up the graves. He has known graves 
with one or more coffins deposited therein kept open for nine or ten days (it 
is supposed to save the cost of re-opening the ground), and in one of the 
graves directly under the back windows of his house he has seen as many as 
thirteen bodies deposited within a period of ten days. That it is frequently 
the practice to disinter coffins to make room for others, and after the mourners 
have left the grave the disinterred coffin has been replaced upon that which 
had just been buried, a surreptitious mode of gaining depth to the eye of the 
parties attending. And during the dark nights, between the hours of twelve 
and three, a.m., he is in the habit of hearing the sound of work in various 
parts of the ground, and a light moving about ; but during moonlight nights 
nothing of the kind is heard. The practice of disinterring coffins was also 
spoken to by other witnesses." 

"Burial-ground, Butler's-place, Horsleydown. — The estimated area of 
the ground is 1,440 square yards, and is entirely surrounded by houses, closely 
packed and densely peopled ; with New Church-grove, St. John's-place, and 
Victoria- grove impinging thereon, and rendered culs-de-sac by the works of 
the South-Eastern Railway. No part of this ground has ever been conse- 
crated ; a schoolmaster residing in the neighbourhood taking upon himself 
the duty of reading the burial-service. The number of burials is estimated 
at an average of 260 per annum. 

" In one corner of this ground a vault has been made, and a communication 
opened with the basement, properly the cellars to several dwelling-houses ; in 
this place human remains in ordinary coffins are deposited. 

" It seems that the proprietor, who is an undertaker, is sole manager of one 



134 THE SECOND OUTBREAK 1849. 

or more burial societies, the members thereof paying a weekly or monthly 
sum in advance, and in the event of death, having paid the amount required, 
they are entitled to be interred in this ground, or in the vaults, upon the 
additional payment of one guinea, extra leaden coffins not being insisted on. 

" The emanations, upon entering the vaults and cellar, I found particularly 
offensive, and the miasma arising from the premises is described by Mr. 
Russell, the medical officer, as the means of engendering disease in this 
locality to an alarming extent ; it not having been free from disease for a 
long period, whilst it has furnished some of the worst cases of Cholera, 
twenty-one in number, together with a vast amount of diarrhoea, consisting 
of no less than 100 cases." 

" St. Stephen, Walbrook. — The area of this burial-ground is estimated 
at 306 square yards, and is closely surrounded on the south and east sides by 
the counting-houses of Messrs. Rothschild, with basements ; on the north by 
dwelling-houses and offices ; on the west by a narrow passage at the back of 
the Mansion-house ; and on the north by the church. The strata consists of 
a dark-coloured soil, from four to five feet deep, overlying a stratum of 
loamy soil, nine or ten feet, resting upon sand from six inches to a foot thick; 
under the last is a deep stratum of marl. The registry is dated 1563. Within 
the last three months, that is, August, September, and October, forty-five burials 
have taken place, whilst the total number recorded amounts to 4,002 ; which 
is equivalent to thirteen layers of bodies in each grave : hence the entire area 
has been dug over for graves no less than thirteen times ; and its present sur- 
face, from the increments of human remains, is two feet nine inches above the 
surface of the passage, and in some parts above the level of the floor in the 
church. It seems from the evidence of the digger, that common graves have 
not been confined to the churchyard, as it has been the practice to make similar 
graves within the walls of the church, and the pavement as a consequence is 
very uneven in parts, a circumstance, there is no doubt, ascribable to the decay 
of the coffins. This fact will sufficiently account for the unpleasant sensation 
experienced by the inhabitants during their attendance at Divine Service : 
some complain of constant headache produced by the smell, and others state 
that they have been obliged altogether to give up attending the church on 
account of it. Mr. Whistler, churchwarden of St. Bennett Sherehog, stated 
that about four years ago the condition of the burial-ground was such, that the 
Rev. Mr. Brandram, in officiating at a funeral, observed it was with the 
difficulty he could perform the service, in consequence of the effluvium greatest 
from the opened grave." 

Mr. Bowie says of — 

"Barking Churchyard, Great Tower-street, City. — Closely surrounded 
on all sides by habitations; densely packed with dead bodies. The effluvia 
from the ground are so offensive, that the inhabitants of the adjoining houses 
a,re frequently obliged to close their doors and windows ; the smell is strongest 
when a grave is opened for a fresh interment, but in warm damp weather it is 
always offensive. One witness says, ' Whenever a grave is opened for a 



THE SECOND OUTBREAK 1849. 125 

funeral, the stench is overpowering. We are obliged to keep the windows 
closely shut down. Some time ago, when a grave was opened ibr the removal 
of the bodies of two children, the stench was so dreadful, that, although 
every precaution was taken to keep the windows closely shvit, it made myself 
and my daughter very sick and otherwise ill.' Another witness stated that 
* the smell in warm weather was extremely unpleasant.' Mrs. S , resid- 
ing at No. 1, says that, when graves or vaults are opened, the smell is so 
exceedingly oftensive as to have caused her to lose several lodgers ; all her 
family have been ill, and she herself is in bad health, owing, as she believes, 
to want of air and the smells from this churchyard. 

"The basement of the Tower Shades, Trinity- square, lies about ten or 
eleven feet below the elevation of Barking churchyard, from which it is 
separated by a passage about eight feet wide, paved with flag- stones. The 
smell here was so extremely powerful and offensive, that I was induced to ex- 
amine the place minutely, when I diccovered several holes in the drain, 
evidently made by rats, and from the peculiarity of the smell I feel assured 
that the churchyard was contributing its full share to the noxious com- 
pound." 

" Pauper Graveyard of St. Bride's, Fleet-street. — This graveyard 
is bounded on the north by Stonecutter-street, leading to Shoe-lane from 
Farringdon-street ; on the south by Harp-alley, separating it from Poppin's 
and Black Horse-courts, Fleet-street; on the east by Farringdon- Street ; and 
on the west by Shoe-lane. It is thus hemmed in on all sides by houses 
thickly peopled. Numerous and earnest were the complaints made to me 
against this burial-ground. One witness, residing in Stonecutter-street, 
stated to me as follows : *' Believes this ground has been used as burial-place 
ever since the time of the plague. Thirty years ago it was a question 
whether it was not quite full ; nevertheless, burials averaging about 100 
annually have continued to take place ever since, until about three months 
ago; that is, three months since May, 1849. At that time a very great mortality 
took place, chiefly among children, in this immediate neighbourhood ; and 
on this account the parish authorities of their own accord ordered burying to 
be discontinued. The smells from this graveyard are often extremely bad ; 
typhus fever has been in her own family three times within eight years ; has 
also lost a child from water on the brain.' 

"This evidence, as I have stated, was taken in May last (1849). A few 
weeks afterwards I was informed that a fatal case of Cholera had occurred 
in the very house in which this witness lived. On inquiry I found that the 
victim was this witness herself. She died on the 27th of June. On ques- 
tioning her husband, he told me that a few days prior to this event an awful 
smell pervaded the house, and that during this time his wife was seized with 
the Cholera. He further stated, that there had been a great deal of illness 
in his family, owing, as he believed, to the bad smells from the burial-ground ; 
that the last bodies buried were only three feet from the surface, and Avere 
just above a barrel-drain onlj^ seven feet deep; and that he was always 
obliged to keep the window shut when the wind blew from the south. 



126 THE SECOND OUTBREAK — 184^9. 

"It is notorious that the smells from the drains and sewers in this neigh- 
bourliood are most offensive. I have myself perceived in them much of that 
sickening odour peculiar to animal substances undergoing putrefaction. The 
amount of disease in this neighboui'hood, the numerous deaths that have 
taken place from fever, and the ravages of Cholera, are indisputable proofs 
of the unhealthiness of the locality, to which I am convinced the state of this 
churchyard contributes a large share." 

" St. Andrew's Churchyard, Holborn. — While inspecting a house in 
Robin Hood-court, I was struck with the appearance of a wall, which was 
damp, glutinous, and spongy, with the lime bulging from the interstices or 
junctions of the bricks. That it was not considered very safe was evident from 
its being supported by two transverse beams resting upon the house itself. I 
recognized at once the cause of its dirty state when I beheld from a window 
the burial-gromid immediately behind it, and learned how densely packed it 
is with dead bodies. Here again I distinctly perceived the usual churchyard 
foetor from the drains." 

"Trinity Burial-ground, Fetter-lane. — There is a little court off 
Fetter-lane, called Mac's-place, in Greystoke-place. It contains about eight 
houses, badly ventilated, most imperfectly drained, wretchedly supplied with 
water, and contaminated with hoarded night-soil in ill-cleansed conveniences. 
On its south side is the burying-ground, adding its unmistakeable odour to 
the other abominations, I received the following statements from the inhabit- 
ants : — 

" A boy died fourteen months ago with all the symptoms of Cholera. He 
had been cleaning away the dirt in the room, which smelt very bad, just 
before he was seized. About the same time four children in the court died 
of fever.' 

" Another witness, living on the side next the graveyard, stated, 

" ' The house smells so bad it is almost impossible to live in it.' The smell 
he compares to that of a dead cat — not an inapt comparison, for certainly it 
was that of camon. He adds that, ' the graveyai'd often smells intolerably, 
and that the water is shockingly bad, tasting as if they were drinking some- 
thing putrefied, and often containing worms alive and more than an inch 
long.' 

" In several of the houses which I examined the inhabitants made loud 
complaints, and stated that there had been a great deal of fever in the court 
within the last twelve or fourteen months. I saw one woman who had just 
recovered from diarrhoea. She told me that her two children were still suffer- 
ing from that disorder. Several others rather reluctantly confessed that 
'they had been similarly affected a short time ago.' The whole place might 
well be termed a ' fever nest.' 

" Wycuffe Burying- Ground, Commercial-road, East. — This is a bury- 
ing-ground near the London Hospital. It is described as being very much 
crowded. A few years ago I myself attended a funeral there. The smell 
was so intolerable that I could scarcely endure it. The earth was obviously 
saturated with decaying animal matter. On my return home I had to change 



THE SECOND OUTBREAK 1819. 137 

my boots, they smelt so disagi*eeably. In a family residing in a house in 
Bedford-square, the windows of which look into this churchyard, and in which 
house I had myself often perceived the unmistakeable smell coming from the 
churchyard, malignant scarlet fever broke out, and one of the children died. 
My brother was a great deal in the room with the child that died. He also 
was seized with ulcerated sore throat and fever of a typhoid character, and 
■was for upwards of a fortnight in the greatest danger. While visiting the 
child at his request, I was sensible of a peculiar odour in the room, and 
remember saying to him, ' I shall think myself fortunate if I escape a fit of 
sickness after that smell, for I have never yet been sensible of it without 
suffering.' Next day I got my clothes rather wet whilst out, and the day fol- 
lowing was in mj' bed with sore throat and fever, and was confined to my room 
for several days. This was about the time that Dr. Lynch and several other 
medical men died of a similar disease." 

As to the vaults of tlie metropolitan churches, Dr. Waller Lewis 
has given a fearful picture of these subterranean places of burial, 
and of the effects upon the health of the living of this mode of 
sepulture. He says : — " The vaults I have visited up to the 
present time are generally in a very disgraceful condition. Those 
least so are St. Martin's-in-the-Fields, St. Bride's, Fleet-street, 
and St. ]\Iary-le-Bow. That of St. Mary-at-Hill is in a condition 
that is a disgrace to any civilized nation. Here are placed some 
150 coffins, in all possible positions, piled one above another — the 
lower crushed by the weight of those above. The great majority 
are broken and decayed, the remnants of mortality falling out 
between the rows of coffins. Enormous cobwebs, and fungi, with 
much dirt and filth, render the inscriptions that remain illegible. 
In the two farther corners large collections of bones are piled 
together, without any attempt at order or decency — a most revolt- 
ing sight. The vault is not ventilated, and the odour of decom- 
posing flesh is extremely foul." Respecting most of the other 
vaults, Dr. Lems but repeats much of the above. 

Such are some of the facts as to the depositories for the dead ; 
but ere the body is transfen'ed to these receptacles, it is made the 
cause of other serious evils, physical and moral. To ponder over 
it, and weigh it well, it does seem an unaccountable sort of sym- 
pathy which can desire to preserve in the house of the living, the 
rotting, putrefying corpse; and that not for one day, or two, but 
for seven or more. And yet this feeling holds, and with a most 
strange tenacity, even among the poorest members of society. 



138 THE SECOND OUTBREAK 1849. 

The hard-working and badly-fed artizan, with many children 
around him, and all occupying but one room, loses a member of 
his family, and, with perverted taste, and unaccountably indif- 
ferent to the best interests of the living, hugs^ as it were, to 
him and his, the body of the dead for at least six days, and 
would still cling to it, although that corpse may be occupying 
the only bedstead he owns, and all the living are obliged to 
make the floor their sleeping-place. Nay, worse; a clergyman 
in a very poor and crowded parish states as follows : — 

" With the upper classes a corpse excites feelings of awe and respect ; with 
the lower classes, it is often treated with as little ceremony as the carcass in 
a butcher's shop. The body is never absent from the sight ; eating, drink- 
ing, sleeping, it is still by their side ; mixed vip with all the ordinary daily 
functions of life, till it becomes as familiar to them as when it lived and 
moved in the family circle. From familiarity it is a short step to desecration. 
The body, stretched out upon two chairs, is pulled about by the children, 
made to serve as a resting-place for any article that is in the way ; and not 
seldom it is the hiding-place for the beer-bottle, or the gin, if any visitor 
should arrive inopportunely. When respect for the dead, that is, for the 
human form in its most awful stage, is gone, the whole range of social sym- 
pathies must be weakened — perhaps blighted and destroyed. They have 
gazed upon death so perpetually, they have grown so intimate with its terrors, 
that they no longer dread it, even when it attacks themselves; and the heart 
which vice has deadened to every appeal of religion is at last rendered callous 
to the natural instinct of fear." 

Again : — 

" There are some houses in my district," says Mr. Leonard, the medical 
officer of the parish of St. Martin-in-the-Fields, " that have from forty-five to 
sixty-nine persons, of all ages, under one roof; and in the event of death, 
the body often occupies the only bed till they raise money to pay for a coffin, 
which is often several days. The body is retained in the room beside the 
living, from five to twelve days. In one instance the corpse had been 
retained twelve days; I could not remain in the room two minutes from the 
horrible stench. The coffin stood across the foot of the bed, within eight 
inches of it. This was a small room, not above ten feet by twelve feet square, 
a fire being always in it ; it was, as in most cases of a like kind, the only 
room for sleeping, living, and cooking in. In another injtance, a mother and 
her infant were brought ill with fever to her father's room, which was ten 
feet square, with a small window of four panes. The infant soon died ; then 
the grandmother was taken ill, and in a few days she also died. The corpse 
of the grandmother lay beside her husband, in the same bed. In the next 
place, the husband was seized with fever, attended with violent delirium, and 
died ; and subsequently two of his children, one within a week, and the 



THE SECOND OUTBREAK 1819. 129 

other within ten days, fell victims to the disease : in short, five out of the six 
inmates of this room died. Found in another similar room the corpse of a 
young person, who had died of fever; the father and mother were just taken 
ill of the same disease. The foot of the coffin was within ten inches of the 
father's head, as he lay upon his pillow, himself in a fever ; in a few days 
another child was seized with the same disease. Cites these cases merely as 
examples of the fatal consequences of the long retention of the body in these 
small and crowded rooms ; they could be multiplied indefinitely. Believes 
that the retention of the corpse in the room with the living is fraught with 
greater danger than even that produced by emanations from crowded grave- 
yards, because when a body is retained in a small, heated, and ill-ventilated 
room, decomposition proceeds rapidly ; the noxious gases evolved cannot 
escape ; they accumulate, and become highly concentrated ; and they often 
prove rapidly and extensively fatal to the living inmates." 

And other witnesses before the Board of Health state, that the 
death of parents, leaving the children orphans and destitute, is a 
frequent occurrence under those circumstances ; and that they 
have sometimes seen whole families swept away. 

" Nearly the whole of the labouring population in my district," says Mr. 
John Liddle, medical officer of the Whitechapel Union, " have only one 
room ; the corpse is therefore necessarily kept in that one room, where the 
inmates sleep and have their meals ; the corpse being sometimes stretched on 
the bed, the bed and bed-clothes being taken off, and the wife and family 
lying on the floor. At other times the corpse is stretched on a board, which 
is placed on chairs : when children die, they are frequently laid out on a 
table. Other deaths often follow the first death in the same family, especially 
in an epidemic season." 

In consideration of these circumstances, and of many more 
of a still more revolting character, the Board, in January, 1850, 
reported on a General Scheme of Extramural Sepulture, the 
result of which was the bringing in a Bill entitled "A Bill 
to make better provision for the Interment of the Dead in and 
near the Metropolis." Some of the details of this measure 
are, without doubt, open to grave objections ; but it is to 
be remarked, that hitherto the chief opposition to the Bill 
has been directed against those parts of it which are in reality 
most beneficial to the public. It is needless to add, that the 
voices which have, without and within the walls of Parliament, 
been raised against the measure as a whole, have proceeded from 
those who have either personally, or through some of the more 
influential of their constituents, a vested interest in existing 
abuses. 



CHAPTER VII. 



Proposed Cures for Cholera. 

The following Tables were prepared with a double object ; 1st, to 
display the folly which could prompt so many men to propose, 
and urge on others, the use of remedies, sometimes even ere they 
themselves had given them a single trial ; to show the absurdities 
into which men who trust to a priori reasoning may be led — for 
the majority of these remedies, opposite and contradictoiy as we 
shall show them to be, were urged on the public or the profession 
with a thorough conviction on the mind of the proposer that the 
vaunted drug met the indications for treatment, or acted du'ectly 
on what each supposed, by some little theory of his own, to be 
the seat of the disease, the organ or function especially at fault; 
and, 2ndly, to make manifest the fact, that none of the so-called 
remedies have been proved to exercise the least influence over the 
progress of the disease they were invariably to cure. 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Mr. Tunstall . . 


Petroleum 


Provincial Me- 
dical and Sur- 
gical Journal. 


Julyl2,1848. 


M. Fourcault. . 


Electro-Magnetic Insulation . 


Proceedings of 
the French 
Academy of 
Medicine, re- 
ported in Me- 
dical Times. 


Aug. 8, 1848. 



PROPOSED CURES FOR CHOLERA. 



131 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


M. Baudismont, 
Professor of the 
Faculty of Sci- 
ences at Bor- 
deaux. 


Warm drinks, large mustard 
poultices to the extremities, 
and friction with hartshorn 
and oil. 


Proceedings ol 
the French 
Academy of 
Science, re- 
ported in Me- 
dical Times. 


I»Ir. Ford . . . 


Capsicum and calomel . . . 


Lancet . , . 


.Mr. Bulley . . 


The use of the spirit vapour 
bath, and stimulating cata- 
plasms to the spine. 


Medical Times 


Dr. Minchowsky 
(Russia). 


Vapour bath of water and 
vinegar. 


Medical Times 


Mr. Jenkins . . 


Strychnia . 


Lancet . . . 


Mr. Beaman . . 


Common salt 


Lancet . . . 


Mr. Twining . . 


Phosphate of soda 


Provincial Me- 
dical and Sur- 
gical Journal. 


Dr. Kriiger Han- 
sen. 


1. p, Misturse pyro tartarica, 
5ij. ; tincturse opiisimplic, 5gs. 
20 drops for a grown person. 

2. p, Cort. cascarill., gr. xij.; 
pulv. aromat. gr. iv ; alumm. 


Times . . . 




crud. gr. ij ; op. pur. gr. j. 


.»'■ • 


Mr. Hancorn . . 


Stimulants, mercury and ses- 
quichloride of iron. 


Lancet . . . 


" An Officer of 
Rankin India." 
Anonymous 
(supported by 
Dr. Thomas 
Wise, Principal 
of the College of 
Dakkah, Ben- 
gal). 


Assafoetida, opium, and black 
pepper. 


Times . . . 


Mr. Hancorn 


Tinct. ferri sesquichlor. . . . 


Med. Gazette 


Dr. Radclyffe 
Hall 


Tartar-emetie ...... 


Lancet . . . 



Aug.21,1848 

Aug.28,1848 
Sept. 2,1848. 

Sept. 2,1848. 

Sept. 2, 1848. 
Sept. 2,1848. 
Sept. 6,1848. 

Sept. -,1848, 



Sept. 9,1848. 



Sept. 14,1848. 



Sept.15,1848. 
Sept.16,1848. 



k2 



132 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed. 



Mr. Brady . 



Mr. Plimnier, 
Melksham, 
Wilts. 



Anonymous, com- 
municated to the 
Board of Health 
by an Officer of 
Rank, long re- 
sident in India. 



Mr. T. Ritson . 



Anonymous (a 
youngPhysieian 
at Berlin). 



Mr. John Bell, 
Newcastle-upon- 
Tyne. 



Central Board of 
Health, Dublin. 



M. Burgui&res 



Nature of the Remedy. 



Chloroform in weak brandy and 
water. 

Chloroform and brandy . . . 



Assafcetida, opium, and black 
pepper, washed down witli 
brandy and water. 



Carbon 



Trichloride of caibon 



Colchicum 



" Powders. — Carbonate of am- 
monia, forty grains. Dissolved 
in half a pint of water ; two 
tablespoonfuls every hour. 

" Powders. — Pulv. cretas c. opio, 
ten grains. One powder every 
half hour until the looseness 
ceases. 

" Pills of powdered opium, each 
one quarter of a grain of opium , 
and two grains of powdered 
ginger, made up with oil of 
peppermint. One every half 
hour imtil the looseness ceases. 

" Pills of mercury and opium, 
each one quarter of a grain of 
calomel, two grains of hydrar- 
gyrum c. cretee, and a quarter 
of a grain of opium, made up 
with oil of caraway. One every 
half hour." 



Acid drinks, (for the purpose of 
neutralizing the alkaline con- 
dition of the mucous lining of 
the stomach and of its secre- 
tions). 



Authority. 



Medical Times 
Medical Times 

Medical Times 



Lancet . . . 
Belgian Papers 

Medical Times 



Date. 
Sept.lG,1848. 
Sept.16,1848. 

Sept.16,1848. 



Sept.23,1848. 
Sept. 23,1848. 

Sept.30,1848. 

Sept.— -,18' 



AcademyofSci- 
ences (Paris), 
reported in 
MedicalTimes 



Oct..2, 1848. 



PROPOSED CURES FOR CHOLERA. 



133 



By wliom Proposed. 



Dr. Shearman 



Dr. Desniyttere 
(Physician ofthe 
Insane Asylum 
at Rouen). 



Mr. Hewlett . 



Dr. Henriques 



Mr. Allen, Ox- 
ford. 



Dr. Kennedy, 
Woodhouse, Lei- 
cestershire . . 



Dr.Ayre, Hull 



Sir. Waddington, 
F.R.C.S.E. 



Dr. Willemin 
(Cairo). 



Mr. Brady and 
Mr. Stedman. 



Nature oi the Remedy. 



For collapse stage, transfusion 
of warm blood, and keep up 
respiration with equal parts of 
oxj'gen gas and atmospheric 
air. 1st stage, common as- 
tringents. 2nd, with cramps, 
tartar emetic and acetate of 
lead with opium. 



Inhalations of oxygen gas. 



Chloroform 



Quinine 



Large doses of calomel at the 
commencement, followed by 
smaller doses of calomel and 
opium, poultices, and friction. 
Injections of hot salt and water, 
or of turpentine in salted gruel. 



Camphor and laudanum in small 
doses, fumigations of vinegar, 
camphor, and fragrant anti- 
septic substances. 



Calomel in one or two gr. doses, 
taken with one or two drops of 
laudanum, and repeated every 
five or ten minutes for succes- 
sive hours. 



Calomel and opium 



Indian hemp (hachish) in the 
form of resinous extract. 



Chloroform 



Authority. 



Lancet 



French Aca- 
demy of Sci- 
ences. 



Provincial Me- 
dical and Sur- 
gical Journal. 

Lancet . . . 



Lancet 



Lancet 



Lancet 



Lancet 



Medical Times. 



Provincial Me- 
dical and Sur- 
gical Journal. 



Oct. 14, 1848 



Oct. IC, 1848. 



Oct. 18,1848. 



Oct.21,1848. 



Oct. 21, 1848. 



Oct. 21, 1848. 



Oct.28,1848. 



Oct. 28, 1848. 



Oct.28,1848, 



Nov. 1,1848. 



134 



PROPOSED CURES EOR CHOLERA. 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Committee of the 


" The following pills may be 






Royal College of 


kept constantly at each station, 






Physicians, and 


and the medical officers may 






the Royal Col- 


leave general directions as to 






lege of Surgeons 


the selection of one or other 






of Edinburgh, 


of these in the first issues to 






and Dr. Suther- 


the patients : — 






land, the Com 


^ Acet. plumbi, jss. ; opii, gr. 






missioner of the 


xii. ; conserv. ros., q. s. ft. 






Board of Health. 


pilulae xvi. Sign. Lead and 

opium pills. 
Jb Tannini, 5ss. ; opii. gr. xij. ; 

pulv. capsici, gr. xvj. ; conserv. 

ros., q. s. ft. pilulffi xvi. Sign. 

Astringent pills with opium. 
Jc Calomelanos, 5ss. ; opii. gr. 

xij. ; pulv. capsici, gr. xvj. ; 

conserv. ros. q. s. ft. pilulse xvi. 

Sign. Calomel and opium pills. 
The doses of all these should 








be as above directed. Along 
with these, in the early stage 
of the disease, and when the 
skin is cold and damp, such 
a stimulating mixture as the 
following, besides the wine 
and spirits, may be used : — 
|b jEtheris sulph. ; spirit am 
moniae aromat. ana. gss. ; tinc- 
turae cinnamom comp. ^i. 
(Misce.) Sign. Two teaspoon- 
fuls to be taken every half 
hour or hour." 






Dr. Searle. . . 


Calomel 


Times . . . 


Nov. 3, 1848. 


Mr. Boy ton, Sur- 


Terchloride of carbon .... 


Medical Times. 


Nov. 4, 1848. 


geon, Oxon. 








Mr. Marsden . . 


1st stage, large doses of calomel 


Work reviewed 


Nov. 4, 1848. 




administered often, avoiding 


in Lancet. 






opium and other narcotics. 








2nd stage, saline solutions to 








be injected into the veins. 






Mr. Hooper . . 


Saline injections 


Report of Meet- 
ing of Medi- 
cal Society of 
London, re- 
ported in 
Lancet. 


Nov. 11, 1848. 


Mr. Morley, 


Ayre's calomel treatment . . 


Lancet . . . 


Nov. 18,1848. 


Blackburn. 









PROPOSED CUKES FOR CHOLERA. 



135 



By whom Proposed. 



M. D., Cheshire . 

Mr. Beardsley 

Dr. Maxwell, 

Calcutta . . . 

Dr. Paxton . . 

Dr. John Hall, 
Eastbourne,Sus- 
sex. 

Mr. Lamprey 

Dr. Keir . . . 



Mr.Belling, Lower 
Edmonton. 



Dr. Maxwell, 
Hyderabad, 
E. J. 

Mr. Lamprey 



Mr. Evans. 
Mr. Evans. 



Nature of the Remedy. 



Iron as a prophylactic 
Salicine 



Lime juice, and other vegetable 
acids. 

Solution of saline substances 

Tincture of rye and spirits of 
camphor. 



Cold affusion 



Warm brandy and water and 
hot baths. 

Warm bath, and emetic of 
mustard mixed with saline 
water. 



Quinine 



Terchloride of carbon 



Saline injections 
Charcoal . . . 



A Spitalfield's A blister to the nape of the neck. 
Apothecary. Calomel, 1 gr. ; with effervesc- 

ing saline, containing from 1 
to 5 minims of tinct. opii, with, 
in some cases, injections into 
the rectum of solution of nitrate 
of silver. 



Dr. Moffatt, Chloroform 

North Berwick. 



Mr. Baines 



Tartarized antimony in col- 
lapse. 



Mr.Garlike.Rick- Nitrate of silver 
mansworth. 



Anonymous (An 
Old and Retired 
Physician), Do- 
ver. 



Powerful emetics of ipecacuanha 
and emetic tartar, followed by 
a large dose of calomel, with 
cathartic extract and oleum 
menthae p., washed down with 
a saline effervescent aromatic 
draught. . 



Authority. 



Lancet . . . 
Lancet . . . 
Medical Times 

Medical Times 
Medical Times 

Work , . . 
Medical Times 

Medical Times 
Medical Times 

Medical Times 

Lancet . . . 
Lancet , 
Lancet . . 



Lancet . . . 
Lancet . . . 
Medical Times. 
Medical Times. 



Nov.25,1848. 
Dec. 2, 1848. 
Dec. 9, 1848. 

Dec. 9, 1848. 
Dec. 16,1848. 

Dec, 1848. 
Dec. 16,1848. 

Dec. 16,1848. 
Dec. 30, 1848. 

Jan. 6, 1849. 

Jan. 6, 1849. 
Jan. 6, 1849. 
Jan. 13, 1849. 



Jan. 20, 1849. 
Jan. 27, 1849. 
Jan. 27, 1849. 
Jan.27,1849. 



136 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Mr. Gillott, Shef- 
field. 


Large dose (15 gr.) calomel, 
followed by 1 gr. every ten 
minutes, the patient drinking 
largely of cold water. 


Lancet . . . 


Feb. 3, 1849. 


Dr. Livingston, 
Leith. 


Calomel and opium in large 
doses in men, opium and 
camphor in women, with warm 
stimulating draughts between 
the doses. 


Lancet . . . 


Feb. 3, 1849. 


Mr. John Thomas, 
Liverpool. 


Liquor potassse arsenitis . . . 


Lancet . . . 


Feb. 10,1849. 


Dr. Niddrie . . 


Calomel and carbonic acid gas . 


Lancet . . . 


Feb. 10,1849. 


Dr. Moffatt, 
North Berwick. 


Chloroform 


Medical Times. 


Feb. 10,1849. 


Mr. Reid, Comrie. 


In the more advanced stages, 
give diluents freely ; stimulate 
the sympathetic by galvanism, 
or the internal use of strych- 
nia and sulphate of manga- 
nese 


Medical Times. 


Feb. 17,1849. 


Dr. Chambers . 


Bleeding and stimuli. Calomel. 


Lancet . . . 


Feb. 17,1849. 


Mr. Crummey, 
Stokely, York. 


Diaphoretics. — Sesqui carbonate 
of ammonia, with spirit of 
sweet nitre, in large doses, 
together with brandy. 


Medical Times. 


Feb. 17,1 849. 


Mr. Pophara . . 


Calomel 


Lancet . . . 


Feb. 24, 1849. 


Mr. Couch . . 


Liquor calcis. If there were 
bilious vomitings with cramps 
about the legs, powders of 
carb. sodae and cuspariae, aa. 
gr. v., with opium. 


Medical Times. 


Feb. 29,1849. 


Dr. John Findlay, 
Glasgow. 


Calomel and opium. Keep the 
patient perspiring by means of 
external heat, applied to centre 
of body. 


Medical Times. 


Feb. 29,1849. 


Dr. Clanny, Mr. 
Ferguson, and 
Mr. Lamotte, 
Practice at 
Monkwear- 
mouth Colliery, 
Nov., 1848. 


Large doses of calomel, followed 
by saline draughts, with fric- 
tions and mustard cataplasms 
externally applied. In some 
cases, where vomiting had 
ceased, a few drops of creasote 
were added to the carb. sodee. 


Medical Times 


Feb. 29,1849. 



PROPOSED CURES FOR CHOLERA. 



137 



By whom Proposed. 



Dr. Maurice 

Margiilies, Phy- 
sician in Ordi- 
nary to His 
Highness the 
Duke of Hesse. 



Nature of the Remedy. 



Mr. Bailey. Prac- 
tice at the 
Pauper Esta- 
blishment of 
Mr. Drouet, 
Tooting. 



Mr. Reynolds, 
surgeon, at- 

tached to the 
LondonHospital. 

Anonymous . 



Mr. Duncan, 

Edinburgh. 



Dr. Kidd, Lim- 
erick. 



Dr. Kelly, Mul- 
lingar. 



Authority. 



Proceedings of 
the Edin- 
burgh Me- 
dico - Chirur- 
gical Society, 
Feb. 21, 1849. 
Reported in 
the Medical 
Times. 



External applications. — Liniment 
of camphorated oil, oil of tur- 
pentine, and liquor ammoniffi. 

When the skin retains its func- 
tions, liniment containing nitric 
acid and sulphuric acid. Sina- 
pisms to the extremities, and 
vapour bath. 

Internal. — For vomiting, small 
doses of fuming nitric acid in 
distilled water. For diarrhoea, 
small lavements, with five or 
ten drops of tincture of opium. 
To arrest diarrhoea, a few drops 
of tincture of nux vomica, and 
of opium. Pulse feeble or 
imperceptible, 1 gr. of phos- 
phorous to 1 drachm of ether ; 
5-10 drops every quarter of 
an hour. For spasms, ipeca- 
cuanha. If the diarrhoea is 
bilious, add some drops of the 
tinctura rhei aquosa to the nux 
vomica and opium. 

In diarrhoea aromatic astrin- 
gents. With sickness and 
vomiting, ether and ammonia, 
with small doses of tincture of 
opium in brandy, and mustard 
plasters to the epigastric region. 
Also, acetate of lead, and in 
the collapse stage chloroform. 



Cold water as a drink, copi- Medical Times, 
ously. 



Mar. 3, 1849. 



Medical Times. 



A plant known by the name 
Zhorabia, discovered on Mount 
Olympus, a decoction of which 
is represented to have the 
power of producing re-action 
in collapse. 

Camphor . . , 



Ipecacuanha, creasote, opium, 
and acetate of lead. 



Nitrous acid blister 



Medical Times. 



Lancet 



Medical Times. 



Medical Times. 



Mar. 3,1849. 



Mar. 3, 1849. 



Mar.24,1849. 



Apr.21,1849. 



Apr.28,1849. 



May 5, 1849. 



138 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed 



Dr. Grieve, Phy- 
sician to the 
Dumfries and 
Galloway Royal 
Infirmary. 



Dr. Hurteaux, 
Paris. 

Dr. Du Maryat . 
Dr. Thomas . . 



Mr. Currie, Black- 
burn. 

Dr. Handvosrel . 



Anonymous, Gla- 
morganshire. 

Anonymous, In- 
dia. 



Mr. C. Rodney, 
Old Burlington- 
street. 

Mr. Owen Evans, 
Wilton-crescent, 
Belgrave-sq. 

Anonymous . . 



Dr. Edward John- 
son, Umberslade 
Hall. 

Mr. J. J. Lema- 
nach, Margate. 

Dr. LeccEur, Pro- 
fessor of Ma- 
teria Medica at 
Caen. 

Dr.Mauget, Paris. 



Nature of the Remedy. 



Pj Tinct. rhei. e. 3vj- ; tinct. 
cardam. e. 5i.ss. ; tinct. opii 
camphorat. gss. ; aq. cinna- 
mon 3vj. M. If this failed, 
then 10 grains of calomel 
combined with one-fourth of 
a grain of morphia. In the 
third stage, dilute nitric acid. 

Tobacco a prophylactic . . . 



Cannabine 



Morphia endermically applied 



Sulphate of zinc to check the 
evacuations. 

Hydro-chlorate of morphine ap- 
plied endermically to check 
vomiting. 



Olive oil 



Copious draughts of rice-water, 
in the early stage ; salt and 
ice in its latter stages. 

Vapour bath .... . . 



Calomel, hydrochlorate of mor- 
phia, cajaput oil, and chloric 
ether. 

Ice-water internally, and wet 
sheets. 



Authority. 



Medical Times. 



Wet sheet 



Calomel gr. ij., mixed with a 
little sugar. 

Chlorate of gold and strychnine. 



Medical Times. 



L' Union Medi- 
cale. 

L' Union Medi- 
cale. 

Lancet . . . 



Union Medi- 
cal e. 



Daily Times . 

Daily Times . 

Daily Times . 

Daily Times . 

Daily Times . 

Daily Times . 

Daily Times . 
Medical Times. 



Date. 



May 26,1849. 



Sesqui-chlorate of carbon, with Medical Times, 
frictions. i 



May26,1849. 
May, 1849. 
May, 1849. 
June 2, 1849. 
June, 1849. 

July, 1849. 
July, 1849. 

July, 1849. 

July, 1849. 

July, 1849. 
July, 1849. 

July, 1849. 
July 7, 1849. 

July 7, 1849. 



PROPOSED CURES FOR CHOLERA. 



139 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Dr. Taulier, of 
St. Yictor-La- 
coste. 


Sulphate of quinine .... 


Medical Times. 


July 7, 1849. 


Dr. Bouet, Paris. 


Four cups of hot and sweetened 
infusion of the common lime- 
tree, mint, balm, or camomile, 
with four drops of volatile alkali 
in each cup. 


Medical Times. 


July 7, 1849. 


Dr. Worms, Phy- 
sician of the 
Military Hospi- 
tal of Gros- 
Caillon. 


Twenty grammes of dilute sul- 
phuric acid to two pints of 
water. 


Medical Times. 


July 14,1849. 


^I. Piorry, France . 


Water thrown into the blad- 
der ! 


Medical Times. 


July 14,1849. 


M. R. C. S., 

Wandsworth. 


Sulphur mixed with a few grains 
of sesqui-carbonate of soda in 
the premonitory stage. 


Daily Times . 


July, 1849. 


Dr. Routh . . 


Transfusion of blood .... 


Lancet . . . 


July21,1849. 


Mr. Greenhow, 
F.R.C.S. 


Mercury, ginger, and opium 


Lancet . . . 


July28,1849. 


Messrs. Ray and 
Farmer, Kent. 


External cold and moisture . . 


Lancet . . . 


July28,1849. 


Mr. A. Palmer, 
Newcastle, Li- 
merick. 


^ Acet. plumbi. gr. ij. ; opii 
gr. ss. ; camphorae gr. ij. M. 
ft. pilula. 


Medical Times. 


July 28,1849. 


Dr. Coppinger, 
Cork. 


Oxygenation of the blood, ef- 
fected bj' Dr. Stevens' treat- 
ment. 


Medical Times. 


July 28,1849. 


Mr. Child . . . 


Ether and opium. 


Medical Times. 


Aug. 4, 1849. 


Dr. Mutrie Fair- 
brother. 


Inhalation of chlorofoiin . . . 


Lancet . . . 


Aug. 4, 1849. 


Mr. Spong. . . 


Dr. Ayre's treatment .... 


Lancet . . . 


Aug. 4, 1849. 


Dr. James Arnott 


Extreme cold ...... 


Lancet . . . 


Aug. 4, 1849. 


Mr. Brainsford . 


Opium and cayenne pepper . . 


Medical Times. 


Aug. 4, 1849. 


Dr. Westmacott . 


Ice 


Medical Times. 


Aug. 4,1849. 


Mr. T.C.Jackson. 


Saline injection 


Lancet . . . 


Aug.11,1849. 



140 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Mr. George M. 
Pritchett. 


Dr. Ayre's treatment .... 


Lancet . . . 


Aug.11,1849. 


Fred.W.Marshall, 
M.B., Hawick. 


Calomel 


Lancet . . . 


Aug.11,1849. 


Mr. Cox . . . 


Dr. Ayre's treatment with mo- 
difications , . 


Lancet . . . 


Aug.11,1849. 


Dr. Carey . . . 


Hot-air bath, to produce re- 
action. 


Lancet . . . 


Aug.11,1849. 


M. Rouget of 
Lisle, France. 


Wrapping in sheets dipped in 
boiling water, and placing the 
patients over the boilers of 
steam engines ! 


Medical Times. 


Aug.18,1849. 


M. Junod . . . 


Depletion by cupping .... 


Medical Times. 


Aug.18,1849. 


Mr. Munday . . 


Dr. Ayre's treatment .... 


Lancet . . . 


Aug.18,1849. 


M. Duchesne Du- 
parc. 


Dysulphate of quinine, as a 
prophylactic. 


Lancet . . . 


Aug.18,1849. 


Mr. Laker . . 


p, Sulph. cup., gr. ss. to gr. ^ ; 

aq. frig., 5 iv. to gij. M. ft. 

haust. cap. cum. haust. seq., 

in dos. alt. qq. j to |^ hor. 
5t> Sulph. quince, gr. v. to gr. 

iij. ; ac. sulph. dil., q. s., solv. ; 

aq- frig- 3 iv. to 5 ij. M. ft. 

haust., ut supra. 
Jb Mur. amm., nit. pot., aa. 

3 ss. ; aq. frig., Oj. M. Bib. 

ad lib., vel p. r. n. 


Medical Times. 


Aug.18,1849. 


Mr. Perry . . . 


Pills composed of camphor, 
opium, calomel, and capsicum. 


Lancet . . . 


Aug.25,1849. 


Mr. Osborn . . 


Dr. Ayre's treatment .... 


MorningChron. 


Aug.29,1849. 


Anonymous • . 


Tinct. ferri and mustard cata- 
plasms. 


MorningChron. 


Aug.29,1849. 


Dr. Richmond . 


On first seeing the patient, two 
or three glasses of good port 
wine ; with seven to ten grains 
of calomel, and as much 
Dover's powder, and a table- 
spoonful of the following : 

Pj Spt. asth. nitrici ; tinct. car- 
dam, comp. aa. 3 i-! tinct. 
camph., tinct. gentianse, tinct. 
zingib., aa g ss. ; tinct. ben- 
zoin, comp., tinct. rhei, spt. 
amnion, aromat. aa 5 ij. ; 
tinct. catechu, vini ipecac, aa 







PROPOSED CURES FOR CHOLERA. 



141 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 






5i. ; pulv. boratis sodas, oxidi 








bismuthi, aa. 3 i. 








In severe cases, with abdomi- 








nal pain, obstinate and perse- 








vering, ointment of the tar- 








trate of antinionj\ 








For the improvement of the 








state of mucous membranes, 








a combination of the nitrate 








of silver, potassa, and bis- 








muth, with columba and 








canella. 








In collapse, port wine and sul- 








phuric ether, tincture of cay- 








enne, and brandy. 








In asphyxia, in addition to a 








blister, a current of electricity 








or galvanism passed along the 








course of the pneumo-gastric 








nerve. 


Medical Times. 


Sept. 1,1849. 


Dr. Philpot 


Oxide of silver ..... 


Medical Times. 


Sept. 1,1849. 


Brookes, Chel- 








tenham. 








Mr. Dearsby . . 


Tinctures of opium, rhubarb, 
capsicum, and cardamums, 
with aromatic confection. 


Lancet . . . 


Sept. 1, 1849. 


Dr. Niddrie . . 


Calomel and carbonic acid gas 
at short intervals. 


Lancet . . . 


Sept. 1,1849. 


Mr. Reece . . 


Dr. Stevens' saline treatment . 


Med. Gazette . 


Sept. 1, 1849. 


Mr. Lincoln . . 


Brandy and cayenne pepper 


Med. Gazette . 


Sept. 8, 1849. 


Mr. Nankivell, 


Dr. Ayre's treatment .... 


Lancet » . . 


Sept. 8, 1849. 


Cornwall. 








Dr. Badeley, 


Dr. Ayre's treatment .... 


Lancet . . . 


Sept. 8,1849. 


Chelmsford. 








Mr. Hewlett . . 


Saline injection 


Lancet . . . 


Sept. 8, 1849. 


Dr. Little . . . 


Alcoholic and saline fluids . . 


Lancet . . . 


Sept. 8, 1849. 


Mr. Reeves, Car- 
lisle. 


Counter irritation over the spine. 


Lancet . . . 


Sept. 8, 1849. 


Dr. Payne . . 


Dr: Ayre's treatment .... 


Lancet . . . 


Sept. 8, 1849. 


Mr. Oliver . . . 


Abstraction of blood .... 


Lancet . . . 


Sept. 8, 1849. 


Mr. Paxon . . 


Chloroform and brandy . . , 


MorningChion. 


Sept. 8, 1849. 


J. D. C, Ports- 


Prussic acid and carbonate of 


Medical Times. 


Sept.8, 1849. 


mouth. 


soda. 







142 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed 


Nature of the Remedy. 


Authority. 


Date. 


Mr. T. H. Leigh- 


The patient to be sponged all 


Medical Times. 


Sept. 8, 1849. 


ton, Llandilo. 


over, except the head and face, 
with a solution of muriate of 
ammonia ; the body to be then 
dusted with pure lime, and 
closely covered up. Oatmeal 
gruel, with plenty of salt in 
it. 






Anonymous , . 


Nitrous oxide 


Medical Times. 


Sept. 8,1849. 


Mr. Hewlett . . 


Saline injection 


Medical Times. 


Sept. 8,1849. 


H. F., Bristol . 


Dr. Ayre's calomel treatment . 


Med. Gazette. 


Sept. 8, 1849. 


Anonymous . . 


Saline purgatives, combined 
with calomel and opium. 


Medical Times. 


Sept. 8, 1849. 


Dr. Wilson . . 


Sydenham's treatment by 
laudanum. 


Lancet . . . 


Sept.15,1849. 


Mr. Pickop, 


Dr. Ayre's treatment .... 


Lancet . . . 


Sept.15,1849. 


Blackburn. 








WorcesterHerald. 


Dr. Stevens' saline treatment . 


Worcester Her. 


Sept.15,1849. 


Dr. Balfour . . 


Lime water and milk, weak sa- 
line solutions, and homoeopathy. 


Medical Times. 


Sept.15,1849. 


M. Raspail . . 


" To preserve yourself from an 
attack of Cholera, you must 
follow the camphor and aloe- 
tic regimen ; employ a nour- 
ishing diet, well seasoned with 
garlic, pepper, and ginger ; 
you must employ frequent 
lotions with the camphorated 
alcohol, or with Ean de Co- 
logne, and frictions with the 
camphor pomatum. 

" Should the disease attack you, 
you must continue the above, 
and a cure will be obtained by 
the following treatment : — A 
vermifuge poultice to the ab-- 
domen, repeated every quarter 
of an hour, with strong fric- 
tions of the camphorated al- 
cohol, while the poultices are 
being prepared. Aloes and 
the vegetable broth are then 
to be taken, and followed by 
the tobacco lavement or ver- 
mifuge. Every hour fifteen 
centigrammes of camphor in 
a glass of tar water ; lotions 
of camphor water on the head. 







PROPOSED CURES FOR CHOLERA. 



143 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 




neck, back, and wrists; fric- 








tions with the camphor po- 








made from the neck to the 








anus ; frequent gargling of 








the mouth with salt and water. 








When you have pursued this 








treatment for a few liours, take 








fifteen grains of crystallized 








calomel, and some castor oil 








half an hour afterwards. 








"When the crisis has passed 








over, sedative and alkalino- 








ferruginous batli, with fric- 








tions on coming out. Strong 








aromatized nourishment as 








soon as your appetite returns. 








Salt and water for drink." . . 


MedicalTimes.* 


Sept. 15, 1849. 


Mr. Ross . . . 


Nitrate of silver and opium 


Medical Times. 


Sept.15,1849. 


Mr. Batten, Pim- 
lico. 


Phosphorus 


Medical Times. 


Sept.15,1849. 


Dr. Davies, Hert- 


Chloroform internally, mixed 


Medical Times. 


Sept.15,1849. 


ford. 


with mucilage. 






Dr. Burton, Wal- 


Opium and dilute acetic acid . 


Medical Times. 


Sept.15,1849. 


sall. 








Dr. Davies . . 


Chloroform ...... 


Lancet . . . 


Sept.22,1849. 


Mr. Herring, 


Inhalation of oxygen gas . . 


Lancet . . . 


Sept.22,1849. 


practical che- 








mist. 








Dr.Tuthill Massy. 


Diarrhoea : — Treatment at 

P> Mist, camphorse ^viij- ; conf. the Exeter 

aromat. 5ij. ; tinct. opii. ir|.xl. ; Dispensary, 


Sept.22,1849. 




sp. ammon. ; c. jij.; tinct. 


laid before 






zing. 5iv. Dos. §j. ter. die. 


Meeting of 






Patients with vomiting : — 


Devon and 






9= 01. ricini ^iv. ; tinct. opii. 


Exeter Pa- 






inxxx. aq. menth. pip. 5iv. ; 


thological So- 






Ft. hst. ss. 


ciety. Re- 






With cramps : — 


ported in Me- 






|b jEth. sulph. 5j. ; sp. ammon. 


dical Times. 






c, 5j. ; tinct. cinnamoni, c, 








5j. ; aquffi ^ss. M. ft. haust. 








Stat, sum. 






Mr. Woodman . 


9j. of calomel with forty drops 
of laudanum. Water drink. 


Ditto . . . 


Sept.22,1849. 



* The Correspondent adds to this plan of treatment as follows : — " I send j'-ou the above, as one of 
the curiosities of medical literature ; yet the unhappy maniac who produced it is regarded as a 
martyr by the people, and many a sturdy patriot will assert to y.ou, ' that Raspail could banish the 
Cholera If the re-actionists would permit him.'" 



144 



PROPOSED CURES FOR CHOLERA. 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Mr. James . . 


Venesection ; opium to throw 
the blood to the surface. 


Ditto . . . 


Sept.22,184.9. 


Sir Alexander M. 
Downie, M.D. 


Dr. Stevens' saline treatment . 


Medical Times. 


Sept.22,1849. 


Dr.H.M. Hughes. 


A large dose of solid opium by 
the mouth, followed by astrin- 
gents, ammonia, and opium in 
fluid form, together with an 
enema composed of a small 
quantity of warm starch, and 
a full dose of laudanum. 

In collapse : — 

Calomel, stimulants, and hot 
blankets. 


Medical Times. 


Sept.22,1849. 


Dr. Beamish . . 


Opium in doSes of vj. to xiij. gr. 


Medical Times. 


S(3pt.22,1849. 


Mr. Mann . . 


Liq. chlorini of the Edinburgh 
Pharmacopoeia, 5j. to 5jss. 


Medical Times. 


Sept.22,1849. 


Mr. John Leigh . 


Strongly rubbing the body in a 
hot salt-water bath, or with 
common salt ; or a turpentine 
glyster. 


Medical Times. 


Sept.22,1849. 


Dr. E. A. Turley . 


Dr. Stevens' saline treatment . 


Medical Times, 


Sept.29,1849. 


Mr. Hunter 


Dr. Stevens' saline treatment . 


Medical Times. 


Oct. 16, 1849. 


Dr. Fairbrother . 


Calomel and opium with chalk 
mixture. 


Lancet . . . 


Oct. 13, 1849. 


Mr. Grove, 
Wandsworth. 


Sulphur mixture ... 


Lancet , . . 


Oct. 20, 1849. 


Dr. Lewis . . . 


Powdered rhubarb,calcined mag- 
nesia, comp. spt. of cinnamon. 


Lancet . , 


Oct. 20, 1849. 


Dr. Maxwell, 
Hydrabad. 


Carbonate of soda. 


Lancet . . . 


Oct. 20, 1849. 


Dr. Hastings . . 


Bisulphuret of carbon . . . 


Medical Times, 


Oct. 20,1849. 


Dr. Tucker . . 


Dr. Stevens' saline treatment . 


Medical Times. 


Oct. 20, 1849. 


Dr. Dingham 


Acetate of lead, combining it 
with opium, stimulants, and 
counter irritation. 

In aggravated forms : — 

Acetate of lead in large doses ; 
cold water always allowed. 

In collapse: — 

Venesection. 


Medical Times. 


Oct. 27, 1849. 


Mr. Giebert, C.E. 


Lemon juice. 


Medical Times. 


Oct. 27, 1849. 



PROPOSED CURES FOR CHOLERA. 



145 



By whom Proposed. 


Nature of the Remedy. 


Authority. 


Date. 


Mr. Griffith . . 


Calomel in large and frequently 
repeated doses, accompanied 
by mercurial frictions. 

In extreme collapse, large doses 
of salt and water. 


Meeting of the 
Medical So- 
cietyofKing's 
College, Oct. 
18,1849. Re- 
ported in Me- 
dical Times. 


Nov. 3, 1849. 


]\Ir. Lafargue 


Dr. Stevens' saline treatment . 


Medical Times. 


Nov. S, 1849. 


Dr. Stoor . . . 


Saline treatment 


Lancet . . . 


Nov. 3, 1849. 


Mr. "Woodman, 
Exeter. 


Dr. Ayre's treatment .... 


Lancet . . . 


Nov.10,1849. 


Mr. Bellasis Mar- 
fen. 


Calomel, opium, and cayenne 
pepper. 


Lancet . . . 


Nov.10,1849. 


Dr. Nankivell, 
Torquay. 


Gallic acid 


Lancet . . . 


Nov.17,1849. 



Excluding secret remedies, tlie mere naming of which would 
occupy a good long summer day, the foregoing are the majority, 
that were proposed during the years 1848 and 1849, for the treat- 
ment of Cholera. We cannot promise the reader that they are all ; 
yet are they enough to make manifest the absurd notions abroad. 
Let us pass in review these remedies, so as to obtain, as it were, a 
bird^s-eye \iew of them. They defy classification. Omitting for 
the moment the complex methods by which Cholera was to be 
vanquished, what were the simple specifics that were to cure — 
infallibly cure — the fearful enemy ? Water, of every temperature. 
'' Wrap the Cholera patient in a cold sheet," says one. " Dash 
cold water repeatedly over the sheet in which he is enveloped," 
says a second. " Ply him well with cold water internally," says a 
third. " Freeze him ; cool his blood to 30° below zero," adds a 
fourth. " Fools that ye are ! " exclaims a fifth, " thus to treat the 
half-dead with Cholera ; I say, wrap him in sheets soaked in boil- 
ing water ; and having thus half-cooked the shivering wretch, con- 
clude the process by placing him over the boiler of a steam- 
engine." Sage adnce, learned Thebans ! The blood is dark, 
and the surface cold. '' My theoiy," shouts one man, ''^ is, that 
oxygen reddens the blood, and by its action on that blood gene- 
rates heat ; therefore make the patient inhale oxygen." " Nay," 

L 



146 PROPOSED CURES FOR CHOLERA. 

rejoins another ; " the blood in the lungs is too bright ; oxygen 
has nothing to do with the generation of heat ; stifle him with 
carbonic acid." " There are cramps present, which cause much suf- 
fering, and, therefore, are they the symptoms especially to be treated. 
Chloroform annihilates pain — let him breathe chloroform." '' It 
is evident," avows one sapient doctor, " that there is no bile in the 
stools — therefore calomel should be administered." " It is plam," 
says another, " that diarrhoea is the great evil — therefore let him 
have opium ;" %. e., the drug which effectually prevents a free flow 
of bile. He is cold and depressed ; what so natural as to stimu- 
late ? The wisdom of the proposal is proved by the numbers who 
recommended its adoption — the folly of the many is manifested 
by the proportion who died under the use of stimulants. " Give 
him alkalies," vociferates one man. "Nay," says another, 
" lemon-juice and acids are the true remedies." " It is simply a 
stage of intermittent fever," maintain some — " therefore," they 
add, " the drug for its prevention and its cure is quinine." " Not 
half potent enough," whispers a supporter of the same theory ; 
" give him arsenic." 

Certain fanatics refuse the use of medicine, but in the course of 
their religious mummeries administer to the credulous a cup of 
olive oil. A patient recovered, and " Eureka ! " shout the popu- 
lace. " Vox et prseterea nihil," say those who wait awhile before 
they decide. Opium, in one man^s mind, is a specific in small 
doses — the twentieth of a grain frequently repeated. " Nonsense !" 
says another, " opium is a specific ; but let it be given in doses of 
from six to twelve grains." The latter has one advantage — if the 
power of absorption yet remains to the stomach, the patient will 
assuredly be saved all further pain, and, if he be a good man, mer- 
cifully provided for in a better world. However, as the duty of 
the doctor is to keep men here, and not to hurry them ofi" there, we 
suppose twelve-grain doses of opium will not be very extensively 
recommended by the profession. 

" Calomel is the specific that will stay every symptom of the 
Cholera — bring back the absent pu.lse — restore the genial warmth 
of the icy skin — bid bloom again the leaden cheek ; give it, then, 
freely, in large doses — give twenty or thirty grains, and see its 
magical efiects ! " " Do so," says an equally devoted admirer of 
calomel, " and you will give the last blow to the dying wretch. 



PROPOSED CURES FOR CHOLERA. 147 

Calomel is the remedy ; but it must be insinuated into the system 
in small doses, frequently repeated." " Bah ! " replies the first, 
"if you follow this man^s whim, the patient will slip through 
your fingers." Then come other infallible specifics — pitch, sulphur, 
phosphorus, and carbon; gold, silvei', zinc, and lead; strichnine, 
salicine, morphine, and cannabine ; hackish and zhorabia ; ab- 
straction of blood, and injection of blood ; perfect repose and 
incessant motion ; to the skin, irritation the most severe, applica- 
tions the most soothing ; stimulants the most violent, sedatives the 
most powerful ; inhalation, flagellation. 

But if these are the simple, what are the complex methods of 
treatment that have been proposed ? A combination of all the 
absurdities contained in the foregoing. Let us just draw the 
reader^s attention to one compound method of treatment. Here 
are the remedies proposed by one gentleman : — port wine, calomel, 
opium, sulphate of potash, powdered ipecacuanha, spirits of nitric 
ether, cardamom-seeds, raisins, caraway-seeds, cinnamon, cochi- 
neal, camphor, aniseed, benzoic acid, benzoin, storax, balsam of 
tolu, aloes, rhubarb, sal-volatile, ipecacuanha wine, biborate of 
soda, oxide of bismuth, spirits of wine, nitrate of silver, tartar 
emetic, potassa, bismuth, calumba, canella, sulphuric ether, cay- 
enne, brandy. 

^'\Tiat a divine afflatus must have distended the mind of the 
proposer of the above remedies, ere he could have conceived the 
idea of bringing such an assemblage of drugs into one prescrip- 
tion ! Think of the wisdom that must have guided the choice of 
each, and apportioned the fitting dose ! And then fancy that all 
are to be administered to the same unfortunate stomach during the 
short space of forty-eight hours ! Byron^s dish, which even the 
good-natured Grimaldi could not stomach — apple-pie with anchovy 
sauce — was nothing to it ! 

One learned Parisian doctor, discarding the hitherto sacred num- 
bers — ^the Pythagorean charm — proposes four cups of sweetened 
lime flower, mint, balm and camomile tea, each to contain four 
di'ops of volatile alkali. Four drops in each of the four cups — 
neither more nor less — sixteen drops of sal- volatile, and a little 
mint tea. Surely nothing could, in one sense, be more simple 
than this ! Oh, yes ! there is one more simple still — milk and 
homoeopathy ! If not more simple, far more disgusting, and not 

L 2 



148 PKOPOSED CURES FOR CHOLERA. 

more sapient, was the proposal for the patients to quafi" goblets 
of fi'esh-drawn blood ! 

It must not be supposed that all these follies are due to medical 
men. No ; many of the remedies were proposed by laymen of all 
varieties, from the preacher to the artizan — learned and unlearned 
— rich and poor; men who had resided in then* own parish from 
the time they first saw light, and men who had journeyed from 
east to west ; men who had never opened a medical work ; and 
men, and women, too, whose inspirations were drawn from the 
pages of Buchan, or whose learning was limited to the herbal 
of Culpepper. In England, confidence was claimed for a drug 
because it was extensively used in India, where Cholera slays its 
hundreds of thousands, uninfluenced by the infallible charm. In 
India, the last mode was imported from England, where noto- 
riously some 40 or 50 per cent, of those attacked with Cholera 
have died. 

The great fact that we leam from all this display of drugs and 
simples is, that none were really of use ; while the practice of 
the homoeopathist affords us a pretty good criterion of what propor- 
tion of those attacked will die when nature is left, to her own 
efforts to effect a cure. From 35 to 50 per cent, of the cases of 
Cholera for which nothing was done, in which no treatment was 
employed, proved fatal. This list of remedies proves how little 
hope can be placed in any of the vaunted specifics hitherto 
examined, to cure Cholera. 

Although he cannot but be struck with the impotence of the 
efforts made to check the progress of Cholera, yet must the his- 
torian of the disease rise from his labours with high admiration 
of the nobleness of the moral character of our profession. 

In it he sees examples of men who sacrifice their own lives for 
the good of their race, with a noble self-devotion far above all 
praise. Curtius, with Rome to gaze and applaud, could offer 
himself a willing sacrifice for his country's good, and win an 
immortal name. The soldier stimulated by a sense of honour and 
burning for glory — enticing, yet empty sound — a soldier with 
his country to vote him thanks when success crowns his efforts — 
with a certainty that if he dies, his country will assume the 
protectorship of his wife and children, will rush to danger, and if 



PROPOSED CURES FOR CHOLERA. 149 

he falls he wins his meed of renown — a nation^s praise^ a monu- 
mental apotheosis^ a page in history. 

But no such incentives stimulate the medical warrior. He must 
encounter death with no glory to be gained by success, with no 
hope of gratitude from his country if he fall. Worn down by the 
fatigues of the day, he must be willing at the call of the most 
abject of his race, suffering perhaps from foul death-diffusing disease, 
to forego the sweets of repose. He, we say, has no hope of gaining 
glory, of winning gratitude; his only reward too often is, that 
consciousness, sweeter to its possessor, however, than the fading 
honours of the " palma nobilis," which 

" Terrarum dominos evehit ad Deos — " 

the consciousness of having done his duty. 

We rejoice to think we belong to a profession, the members of 
which have, during the late epidemics of Cholera as on other 
occasions, showed that with the hope of such rewards alone before 
them, they could, under the most disheartening circumstances, 
continue their arduous and humane labours with unfailing energy. 



150 THE SALINE TREATMENT. 



CHAPTER VIII 



The Saline Treatment. 



In the preceding chapter we have detailed many of the various 
methods which have been recommended and employed for the 
treatment of Cholera. Nearly every powerful remedy known to 
medical men has been tried and failed. The mortality of the 
disease was never reduced much below what may be termed the 
natural standard^ viz.^ about 50 per cent, of the cases treated in 
any given and extensive series of attacks. The truth is^ that the 
great majority of practitioners administered their remedies without 
any clear notion of the real nature of the disease treated by them, 
or of the object to be attained by the treatment employed. They 
gave drug after drug, draught after draught, heaping a Pelion 
of pills upon an Ossa of powders, in the vain hope of dis- 
covering a specific to immortalise their names. 

By a blind perseverance in this course a heavy blow was in- 
flicted on the science of medicine, and the public compelled to 
draw the melancholy conclusion that Cholera was an incurable 
disease — a scourge completely beyond the resources of the 
healing art. But He, who for his own wise purposes permits 
evil to prevail, at the same time furnishes man with the means 
of counteracting its effects. Cholera does not form an exception 
to the general law which teaches us that Nature, when properly 
aided by those means which knowledge affords, is capable of curing 
most, if not all, complaints. Humanity has not yet been afflicted 
with any acute disease, in itself and of necessity, mortal. Ex- 



THE SALINE TREATMENT. 151 

perience lias shown that plague and yellow fever — two maladies 
at one time regarded as incurable — may be grappled with and 
subdued. And so it is with Cholera. If the mortality from this 
pestilence has hitherto fallen little short of 50 jyer cent. — if it 
has slain its thousands and its tens of thousands in every quarter 
of the habitable globe — man should blame his own ignorance or 
obstinacy^ instead of attributing the misfortune to a visitation from 
on high. The important discovery of Dr. Stevens, relative to the 
action of neutral saline substances on the blood, has abundantly 
proved that Cholera can be mastered, and its mortality reduced 
to an insignificant per centage. Few, however, are prophets in 
their own country; and history teaches that great discoveries 
have at the outset invariably met with blind and determined oppo- 
sition. Truth is seldom received at once. The trials of adversity 
seem necessary for its ultimate and immutable foundation. Men 
cling with pertinacity to preconceived opinions, and a false sense 
of pride prevents public bodies from acknowledging error. Hence, 
perhaps, one cause of the determined opposition which the disco- 
veries of Dr. Stevens met with almost from the very commencement, 
and hence the load of calumny or misrepresentation which has been 
accumulated, with all but crushing effect, during a period of nearly 
twenty years, on one of the most upright and philanthropic 
members of the medical profession. 

The discoveries of Dr. Stevens were received with incredulity. 
As truth began to dawn, and error to fade before it, his doctrines 
were misrepresented, that they might be the more easily over- 
thrown. The saline treatment had been applied with the most un- 
expected and astonishing results to a large number of cases in the 
same establishment. Public attention was aroused — converts were 
daily increasing — the triumph of truth was all but assured — when, 
as in the fable of old, it would appear as if vipers had been sent 
to strangle the infant at its birth : Dr. Stevens was accused of 
having deliberately perverted facts to suit his own purposes — of 
hanng affirmed that to be which was not — in a word, of having 
made false returns of the cases treated by himself. So artfully 
were these accusations prepared — with such perseverance were 
they propagated both at home and abroad — so strangely did the 
authorities refuse to inquire fairly into a subject with which the 
lives of thousands and the welfare of the whole community were 



153 THE SALINE TREATMENT. 

inseparably connected — that up to the present moment Dr. Stevens 
is regarded by the public^ ignorant of the truth^ and by many in 
the profession, as little better than a detected impostor. 

We shall, however, here confine ourselves to a succinct account 
of the saline treatment, as recommended by Dr. Stevens, and to a 
rapid, but we trust a faithful, sketch of its early histoiy in this 
country. 

The method we are about to describe was that followed with 
such decided success at the Coldbath-fields Prison, and elsewhere. 

Premonitory Symptoms. — Acting under the belief that the pre- 
monitory bowel complaint is an effort of nature to expel the poison 
from the blood and the body, on the first appearance of the pre- 
monitory symptoms a seidlitz powder was administered ; but if the 
patient experienced a sense of sinking without diarrhoea, more active 
saline purgatives were then employed. The aperient generally 
used was sulphate of magnesia, from one to three drachms of 
which were added to the seidlitz, the whole taken in a state of 
effervescence. \^Tien this commenced acting on the bowels, the 
patient was encouraged to drink freely of thin beef-tea, well 
seasoned with common salt. If vomiting was present, a sinapism 
was applied to the epigastrium : if the thirst was intense, seltzer, 
soda, or plain water, was allowed ad libitum. By the employment 
of these simple means not more than one in twenty-five cases 
passed into the second stage — that stage only which can be properly 
called Cholera. It should here be stated that those cases alone 
which passed into this second stage were entered in the Journal as 
cases of Cholera by the prison authorities ; and that such only 
are included in the numerical statements of Dr. Stevens. 

Second stage, or that of developed Cholera ; the diagnostic symp- 
toms being cramps, coldness, or sinking prostration. The fol- 
lowing powder, 

P) Sodas sesquicarb., 9j. ; sodii chloi"id. 5j. ; potass^ chloratis, gr. vii. 

was dissolved in half a tumbler of water, and administered in 
severe cases every half hour — in some malignant cases every fifteen 
minutes ; while in those cases which were not very severe it was 
given every hour. The frequency with which the dose was 
repeated in each particular case varied according to the circum- 
stances of that case. In every instance the saline Avas continued 



THE SALINE TREATMENT. 153 

until the circulation was fairly restored : when once that point was 
gained^ the intervals between the doses were lengthened; and when 
re-action was completely established it was left off by degrees. In 
extreme cases the dose of the chloride of sodium was increased to 
two drachms, and in some cases to even more than this. In those 
cases where the stomach was very irritable, a dilute solution of 
chloride of sodium was thrown up into the intestines ; the tempe- 
rature of this saline enema being as high as the patient could 
easily bear, which, as a general rule, was about 100 degrees 
Fahrenheit. When properly used, this is a means of great value. 

When the stomach was irritable, the use of the saline powder 
was occasionally suspended, and common effervescing mixtures, or 
small doses of the common soda powders, with an excess of the 
carbonates, were frequently used, until the vomiting abated, and 
then the carbonate of soda, with larger doses of the chlorate of 
potash, were given without the chloride of sodium, or frequently, 
in such cases, the chlorate of potash was given by itself, in doses 
of ten grains each. 

A large mustard poultice was applied in such cases to the 
epigastric region the moment the patient came under treatment. 
When the saline powders were used at the time the stomach was 
very u'ritable, it was deemed advisable to dissolve them in a very 
small quantity of water. When cramps supervened, the extremities 
were rubbed with hot flannel. The pain produced by the spasms 
in the muscles was not only relieved by the frictions, but by this 
and the application of sinapisms to various parts of the body the 
temperature was increased : an object of no trifling importance 
in the treatment of Cholera. In this stage of the disease, 
as in the premonitory symptoms, seltzer or cold water was 
allowed the patients ad libitum. A strong infusion of green 
tea was also occasionally used in severe cases, and apparently 
with advantage. 

The patients were invariably placed in a room in which a large 
fire was kept day and night. 

The ejections and all other impurities were removed immediately 
from the patient's room — a pm'e atmosphere and great clean- 
liness being considered essentially necessary to a successful issue ; 
the infected wards were fumigated with gunpowder ; and no solid 
food was allowed the patients for a few days after recovery. 



154 THE SALINE TREATMENT. 

In exceedingly malignant cases^ or when the patient was not 
seen till late in the disease, the stage of collapse being well marked, 
the most active measm-es were adopted. An ounce of the chloride 
of sodium, with half a drachm of the chlorate of potash or the 
chloride of potassium, was immediately given in cold water, and 
repeated, if necessary, every half hour until the patient had taken 
about three doses of this strong solution. If re-action ensued, 
it was kept up by the common saline powders ; but if the 
strong saline given by the mouth failed, as a last resource, a 
saline fluid was injected either into the intestines or into the 
veins. 

In scarcely any one case left to Dr. Stevens' care was the smallest 
quantity of opium or other narcotic administered — above all, in 
the early stage. Dr. Stevens' experience leads him to consider 
these drugs to be as fatal in Cholera as they are in either the 
African typhus, or the seasoning fever of the West Indies ; and he 
never failed urgently to request all those who desired to test the 
efficacy of the saline treatment, to place implicit confidence in it, 
and to trust to it alone. To poison the patient with opium, or with 
prussic acid, to exhaust his nervous system mth galvanic shocks, to 
depress the vital powers with extreme cold, and then — because at 
the same time with these deleterious agents salines had been 
administered — to declare the patient had fallen a victim to Cholera 
while under the treatment recommended by Dr. Stevens, was not 
only untrue, but, at the same time, to oiEFer a serious impediment 
to the successful treatment of the disease. For results obtained 
by such unjustifiable proceedings. Dr. Stevens cannot be respon- 
sible ; nor can such cases be admitted as evidence in determining 
the value of the non-purgative salines as remedial agents in the 
treatment of Cholera. 

The mode of treatment we have described was practically ap- 
plied, for the first time, during the outbreak of Cholera which took 
place in Coldbath-fields Prison, in the year 1833. It was, as 
we shall presently see, eminently successful. Nevertheless, the 
doctrines of Dr. Stevens were ridiculed, his motives impugned, 
the results of his practice misrepresented, and its utility de- 
nied. Hence, for a time, all remonstrance was useless, and truth 
itself obscured in an impenetrable cloud of darkness. To dissipate 
that cloud is now our object : nor is the task a difficult one. We 



THE SALINE TREATMENT. 155 

have merely to lay before our readers a " plain, unvarnislied tale'^ — 
a sober statement of facts, to the truth of which we pledge our- 
selves, — leaving an impartial profession to draw their own con- 
clusions. 

Epidemic Cholera broke out in Coldbath-fields Prison on the 
5th of April, 1832, and continued to prevail there until the 27th 
December in the same year. A short interval of repose, however, 
occurred between the 11th of May and the 3rd of June. We shall 
therefore distinguish the two attacks, — the first prevailing from 
April 5th to May 11th; the second, from June 3rd to December 
27th, 1832. 

The first cases were treated in the manner recommended by the 
Board of Health. This plan failed. Mr. Wakefield, sm'geon to 
the prison, having become acquainted with the views of Dr. Stevens, 
came voluntarily forward, and invited that gentleman to undertake 
the treatment of a certain number of the Cholera cases — four 
deaths having already occurred. Dr. Stevens at once consented, 
and undertook, on the 10th of April, to superintend the applica- 
tion of the saline plan of treatment. This method was assiduously 
employed in the cases admitted from the 10th to the 30th of 
April by Dr. Stevens and Mr. Wakefield, and from the 30th April 
to 11th May by the latter gentleman. 

In the first irruption, dating from April 5th to May 11th, there 
had been a total number of 165 cases of Cholera, 30 of which 
were cases of collapse. It appears from the books of the prison, 
that nine deaths had occurred in this number of cases. In a 
letter, dated April 25th, which Mr. Wakefield wrote to the 
Editor of the Medical Gazette, he said, alluding to the cases 
which had then come under his care, " Four of the first cases 
were treated in the common way, and every one of them died." 
This reduces the nine deaths, so far as the saline treatment is 
concerned, to five. But we also have Mr. Wakefield's admission 
of another very important fact, viz., that as the numbers 
admitted into the infirmary increased, " it became necessary to 
dismiss those who appeared least ill;" the consequence of which 
was, that a relapse set in in two cases, "and though every 
attempt was made to save them, yet they both died after a very 
short illness, with the symptoms of Cholera in its most virulent 
form.'^ Deducting then these six cases from the gross number of 



156 THE SALINE TREATMENT. 

nine deaths in the first irruption^ we have only three deaths 
left. The records of the prison also testify to the truth of the 
above facts, independently of Mr. Wakefield^s public statements. 
It appears, from the same documents, that two of these three 
deaths were caused by other diseases, and not by Cholera. Both 
these patients had completely rallied from the attack of that 
disease ; one '' who was of very delicate habit " had been attacked 
with Cholera on the 14th of April, and had recovered, but was seized 
with fits a month afterwards, and died on the 15th of May; while 
the other, although every symptom of Cholera had been entirely 
subdued, died on the 24th of April from fever of a typhoid form.* 
We then have one death left to be accounted for under the saline 
treatment, the eight others being disposed of as above. It is also 
to be observed that in this case, it appears from the books of 
the prison (though we may grant the patient was under the saline 
treatment all along) that hot brandy-and- water had been given 
him occasionally. We shall, however, take this as one death 
occurring under the saline treatment, and the result is, in the 
first irruption : — 165 cases of Cholera (and by Mr. Wakefield^s 
own admission up to the 25th of April, twenty-five of these had 
been in a state of collapse,) with one death, under the saline treat- 
ment, in 159 cases, or one death and 158 recoveries. 

This is the whole truth respecting the first trial of the saline 
treatment in this country; and we challenge any one to prove 
the contrary. We have seen and carefully studied the official 
documents which sustain the truth of our statement, and we are, 
moreover, enabled to say that these documents, with an explanatory 
text, will be submitted to the judgment of the profession. 

That such a result should excite envy and opposition might 
be anticipated ; since persons having authority from the State had 
already advocated doctrines and recommended a practice directly 
the reverse of that which Dr. Stevens had inculcated. Both could 
not be right. A determined efibrt was therefore made to mislead 
the public, and induce them to believe that Dr. Stevens was wrong. 

In this attempt. Sir David Barry w^as the principal agent; 

* Respecting this case, Mr. Wakefield placed the following notes on the Prison Books : — 
"Frederick Cook, aged 25, was admitted into the infirmary on the II th of April, 1832, with 
confirmed Cholera. From the attention paid to him, and the remedies prescribed, the symptoms 
of Cholera were subdued ; but fever of a typhoid form supervened, which produced his death on 
the 24th ult. (Included with the deaths from Cholera.)" 



THE SALINE TREATMENT. 157 

while it appears that Mr. Wakefield^ so lately the ardent advocate 
of the saline treatment, was induced to modify, if not abandon, 
opinions which he had recorded in the most decided manner. 
And then Sir David Barry, with more patronage at his disposal 
than he could or well knew how properly to employ, next prevailed 
npon Dr. O'Shaughnessy to attempt the condemnation of the 
saline treatment in the pages of the Lancet. 

The second outbreak of Cholera m Coldbath-fields Prison 
afforded these parties an opportunity of carrying into effect their 
hostility to the remedial measures proposed by Dr. Stevens j and 
passing, then, to this second irruption, which dates from June 
3rd to December 27th, we find 337 cases of Cholera recorded in the 
books of the prison, and of which 201 were in a state of collapse. 
Of these thii'ty-five terminated fatally. Are these thirty-five deaths 
to be attributed to the saline treatment ? We shall show the con- 
trary. It appears that during the temporary absence of the Governor, 
Col. Chesterton, Mr. Wakefield had been led to abandon Dr. Stevens' 
plan on or about the 1 3th of June ; the result of this was, that 
from the 14th of that month to the 25th inclusive (a period 
of eleven days) no less than fom'teen patients were lost, not under 
Dr. Stevens' saline treatment, but in consequence of its abandon- 
ment ; five of these deaths occurred in one day — namely, on the 
22nd, or, rather, from twelve o'clock at noon of the 21st to twelve 
o'clock at noon of the 22nd. 

This state of things appears to have aroused Mr. Wakefield to 
a sense of danger. Finding that affairs were proceeding from bad 
to worse, he sent for Dr. Stevens, on the night of the 21st, to visit 
the prison, on the pretext that " the salines had now failed to pro- 
duce their usual effect." Dr. Stevens visited the prison without 
delay — and, to his amazement, found that the so-called saline 
treatment was anything but conformable to the plan which he 
had laid down, and which j\Ir. Wakefield himself had adopted, with 
so much success, dming the former outbreak. 

After an intei-view at the prison with Dr. Stevens late on the 
night of the 21st, Mr. Wakefield promised that in future the saline 
treatment should have full force in that establishment. The mis- 
chief of its abandonment, however, did not cease until the 25th. 
We may here state, that early on the morning of the 22nd, and 
in consequence of what had taken place the evening before, Dr. 



158 THE SALINE TREATMENT. 

Stevens and Mr. Crooke;, Dr. Stevens' assistant, returned to the 
prisonj and resiuned the management of the Cholera patients. 

The opponents of Dr. Stevens seem to have thought the 
temporary absence of the indefatigable and very anxious 
governor — for Colonel Chesterton personally superintended 
almost every case during the first irruption — a favourable 
moment for striking a decisive blow ; and Sir David Barry, per- 
sonally on the 25th of June, and indirectly on the 23rd, in a 
leading article of the Lancet, urged Dr. Stevens to demand a 
commission of inquiry into the merits of the saline treatment. 
This, however, he judiciously declined. But a commission was 
still thought necessary ; and accordingly a paragraph was inserted 
in the Glohe newspaper, of the 27th of June, announcing a 
rumour ''^that the Cholera had raged, within the last few days, 
among the prisoners, with great violence ; and that during the 
last twelve days upwards of one hundred prisoners had been 
attacked, and ten or eleven deaths occurred." 

This statement naturally excited alarm. Sir David Barry, 
having obtained from the higher authorities the appointment of 
the wished-for Commission, of which he was nominated the head, 
and his friends Dr. Maling and Dr. Macann members, was ordered 
to inspect the prison on the same day, the 28th. Sir David 
Barry, attended by Dr. O^Shaughnessy, had, it should be men- 
tioned, made a semi-official visit on the 27th. 

The reports of the inspectors — official and semi-official — an- 
nounced a fact of the most astounding nature, for which few 
indeed, were prepared. They affirmed, in published documents 
and in official communications to Government, that " not a single 
case of Cholera existed in the prison on the 27th of June, and 
that there were only three cases of the disease in the prison 
on the 28th.'^ Dr. Stevens, on the other hand, had spoken of 
having seen forty Cholera patients there on the 25th; Colonel 
Chesterton, the Governor of the prison, in his report of the 
28th, had mentioned seventy; and in the article in the Globe, 
as we have seen, the attacks within the last twelve days (previous 
to the 27th), had been estimated by Sir David Barry and his 
friends at one hundred. 

The conclusion from all this is obvious. Sir David Barry and 
Dr. O'Shaughnessy denied the existence of a single case of real 



THE SALINE TREATMENT. 159 

Cliolera on tlie 27th. The Government inspectors admitted the 
existence of only three cases on the 28th. The assertions of Dr. 
Stevens and Col. Chesterton were therefore falsified^ and Cholera 
could not be said to prevail in the prison. Its existence there — 
manifested by three cases only on the 28th — was a matter of the 
most insignificant import. Hence the assertions_, deductions, and 
claims of Dr. Stevens were reduced to zero ; hence was he exhibited 
to the world as an impostor, and to this very day is regarded, even 
by the charitable, in the light of a fanatic. So strong, indeed, 
was the impression produced on the minds of the Government 
authorities by the mis-statements of Sir Da\dd Bariy and his 
friends, that when Dr. Stevens, about to leave England for a long 
period, did apply to the Privy Council, on the 8th of September, 
1832, for a commission of inquiry, he was met with a refusal, on 
the Yevj grounds that Sir David Barry^s official report, con- 
fii-med by a " return " from the surgeon of the prison, had proved 
the great exaggeration of the statements made by him relative to 
Coldbath-fields Prison. 

The Privy Council, however, moved by the paragraph in the 
Globe, already mentioned, and by a note from the Governor, on 
the following day, stating the existence of seventy €ases of Cholera 
in the prison, appointed a commission to visit the establishment on 
the 28th of June ; and likewise ordered a return of the state of the 
prison from the surgeon. Taking advantage, however, of the loose 
manner in which the order from the Privy Council was drawn up, 
]\Ir. Wakefield sent in a " nominal return," not of all the Cholera 
patients then in the prison, but a list only of those attacked on 
the 26th, 27th, and 28th. Such a return was manifestly calcu- 
lated to throw no light on the real condition of the prison some 
days previously, nor to confirm or overthrow the statements of Dr. 
Stevens and Colonel Chesterton; which, being unable to con- 
tradict. Sir David Barry and his fellow commissioners evaded the 
difficulty by silence respecting that which had occurred previous 
to the 26th, stating " it is almost needless to observe that no part 
of the preceding notes or statements is meant to refer to any time 
or circumstances connected with the patients, anterior or posterior 
to the moments at w^hich they were seen by Dr. O^Shaughnessy, 
Mr. Maling, Dr. Macann, and myself. (Signed.) D. B." — 
Lancet, page 457, 1832, vol. I. Mr. Wakefield, however, in his 
return of the 28th June, states, " In relating these cases for the 



160 THE SALINE TREATMENT. 

information of the Privy Council, I beg leave to observe that the 
Cholera made its re-appearance in this prison on the 3rd inst., 
with a degree of malignancy far surpassing the violence of the 
former attack ; and that during the period between its arrival 
until the present time_, upwards of a hundred cases have occurred 
with different degrees of severity, out of which number twelve 
cases have tei*minated fatally : but I am happy to add, that the 
remainder are at this moment in different stages of convalescence, 
and that the disease appears to be gradually subsiding/^ And 
here we would ask, if Sir David Barry knew, as he must have 
known from this report, that Cholera had raged in the prison in its 
most malignant form from the 3rd to the 28th of June, what could 
his motive be for fixing on the three days in which the smallest 
mortality had lately prevailed ? It was thus the world were made to 
believe that the statements of Dr. Stevens and Colonel Chester- 
ton were untrue ; while the estimates of those gentlemen, as shown 
by the prison records, were imder the mark, instead of ove?^ it ! 

But this is not all. The '^nominal return" of Mr. Wakefield 
was completely at variance with the official statements of Sir David 
Barry; and consequently, either the prison-books, signed by Mr. 
Wakefield, and attested by the visiting magistrates, recorded false- 
hoods, or Sir David Barry and his friends suppressed the truth. 
This can be further demonstrated in a few words. 

Such had been the result of six days^ appropriate treatment by 
Dr. Stevens, that Sir David Barry denied the existence of a single 
case of Cholera in the prison on the 27th of June. 

Mr. Wakefield^s "return" proved that twenty -nine cases of 
Cholera had been admitted into the infirmary -wards on the 26th 
and 27th ; and of these cases, five were returned as cases of con- 
firmed Cholera, and this not in the "collapse column," but under 
the head of premonitory cases. 

Laying aside, then, for argument's sake, twenty-four cases, we 
have, by Mr. Wakefield's own showing, at the lowest estimate, 
five decided cases of Cholera in the wards at a moment when 
Sir David Barry denied the existence of a single case. Of twenty- 
two patients admitted on the 25th, six ultimately died ; and we 
may deny, without fear of contradiction, that the history of 
Epidemic Cholera in public establishments has ever offered an 
example of so sudden a disappearance as pretended by Sir David 
Barry and his colleagues. 



THE SALINE TREATMENT. 161 

The " nominal retin-n " of Mr. Wakefield did not exhibit a 
single case under the head of " Collapse." All the collapse cases 
were strangely transposed to the column which embraced a list of 
patients labouring under premonitory sjnnptoms ; yet the infirmary 
records wliich bear Mr. Wakefield's signatm-e prove, not only that 
these fiv'C cases were collapse cases, but also that from the 3rd 
to the 28th of June, 1833, no less than fifty-eight cases of 
'•^ collapsed," or "confirmed" Cholera M^ere admitted into the 
wards of the prison. 

Although we will not here enter more fully into " this strange, 
eventful history," we may mention that the statements of Dr. 
Stevens, relative to the condition of the prison, were voluntarily 
confii-med by Mr. Rotch, and others of the visiting magistrates; 
by Colonel Chesterton, the Governor of the prison ; and by Mr. 
Ousby, the chaplain to that establishment. On the records of 
the prison, as well as on the independent and impartial testimony 
of men far above suspicion, we might rest our case. 

But we must now return to, and briefly conclude our history of, 
the second attack of Cholera in Coldbath-fields Prison. 

It has been shown, at page 157, that 337 patients, of whom 
thu-ty-five died, were attacked during this second outbreak ; and 
that thirteen of the thirty-five deaths cannot be attributed to the 
sahne treatment. Twenty-tvfo, therefore, remain to be accounted 
for ; but truth, and justice to Dr. Stevens, both demand that this 
number be still further reduced. It is a remarkable fact, as it 
appeal's from the prison records, that of 138 patients admitted 
from the 26th of June to the 27th of August inclusive, only five 
cases had terminated fatally. Consequently, comparing four 
weeks of Dr. Stevens' treatment mth one week of the unsuccessful 
treatment of the Board of Health, we find that from the 1st of 
August to the 27th of the same month, under the saline treat- 
ment, not one death from Cholera occurred, although in that 
period thirty-eight cases of the disease were recorded; but that 
in one week, from the 28th of August to the 5th of September, 
no less than nine cases terminated fatally ! How is this to be 
accounted for ? We say again, and have the means of proving, that 
not one of these nine cases had been under the saline treatment. 

This, then, being the state of the facts, we have during the 
second iiTuption 337 cases, and thirty-five deaths. We also find 

M 



162 THE SALINE TREATMENT. 

that in tlie last fatal case, viz., that ou the 20th of December, the 
saline treatment had been abandoned for an experimental trial of 
cold affusion ; thus giving another case in reduction of the deaths 
under the saline treatment, or a sum total of deaths vi^here the 
salines had not been used of twenty-three out of thirty -five. The 
following, then, will be the correct statistics of Dr. Stevens^ treat- 
ment during both the first and the second irruption : 

Cases of Cholera. 

1st irruption, from April 5 to May 11 . . 165 . . Of this number 159 were 

treated on Dr. Stevens' plan, 
with a result of 1 death and 
158 recoveries. 

2nd irruption, from June 3 to Dec. 27 . . 337 . . Of this number (337), 

287 of which had been 
treated by tlie saline reme- 
dies, there were 11 deaths 

and 280 recoveries. 

. 502 



RESULTS OF TREATMENT. 

In the 1st irruption . . 1G5 cases . . 9 deaths. Of these — 

4 were not under the saline 

treatment. 
2 died of other diseases. 
2 died from relapse, being dis- 
missed as convalescent too 
soon ; and 

I died vmder the saline treat- 
— ment. 

9 

In the 2nd irruption . . 337 cases . . 35 deaths. Of these — 

24 died in consequence of the 
abandonment of the saline 
treatment, first on the 13th 
of June ; again on or about 
the 27th of August ; again 
on the 20th of December; 
and 

II died under the saline treat- 
— ment. 

35 



THE SALINE TREATMENT. 1G3 

We shall now, however, proceed to contrast more fully the results 
of Dr. Stevens' treatment in the second outbreak, as compared 
with other plans pursued when the salines were abandoned. We 
have before stated that Mr. Wakefield gave up administering 
Dr. Stevens' salines on the 14th of June. Now, the second 
outbreak commenced on the 3rd of that month, and what do 
we find to have been the result of Dr. Stevens' plan up to 
the time of its abandonment on the 14th ? Just this — that 
from 3rd of June to the 13th, inclusive, there had been seven 
cases of Cholera, and a result of one death (the first case) and six 
recoveries. But from the 14th (the day after the discontinuance 
of the salines), to the morning of the 22nd of June — Mr. Wake- 
field, during the night of the 21st, having been induced to allow 
the resumption of the saline treatment — there had been twenty-six 
cases of Cholera, with a result of nine deaths, and seventeen 
recoveries. And now with this — the proper treatment — in force, 
what was the result ? Why, that from early on the morning of 
the 22nd, when Dr. Stevens and Mr. Crooke took the manage- 
ment of the Cholera patients, to the 27th of August, no less than 
189 cases of Cholera had been admitted, and out of this number 
the deaths only amounted to thirteen, — or thirteen deaths and 176 
recoveries. 

It is necessary, however, to remark, respecting these thirteen 
deaths, that nine of them at least could not be fairly attributed 
to the saline treatment ; first, because seven died the same day 
they were brought into the infirmary of the prison, being at the 
time of admission in a dying condition ; and the other two died, 
one fourteen and the other seventeen days after the Cholera attack. 
Hence, if we deduct these nine deaths from the thirteen, we have 
four left as resulting from the saline treatment in the above 189 
cases. 

Finally, from the 31st of August to the close of the year and 
the end of the outbreak, ninety-eight cases of Cholera occurred, 
and of these three proved fatal : but one of these three patients 
died after the salines had been abandoned for the foolish experi- 
ment of cold aiFusion. 

This being a true statement of the case, with the greatest con- 
fidence we here ask, what practitioner, in respect to any zymotic 
diseases, can boast of success such as this ? 

M 2 



164- THE SALINE TREATMENT. 

To sum up this statement of the second outbreak, we have as 
the result : 

Cases. Deaths, 

Under the saline treatment ...... 287 7 

Under the old, or no-treatment , . . . .50 19 

Patients who died 14 and 17 days after the attack of 

' Cholera 2 

Patients who died the same day as admitted for treat- 
ment ......... 7 

Total cases and deaths in the second outbreak . . , 337 35 

Under the Saline Treatment. | Under the Old Treatment. 

Cases. Deaths. Cases. Deaths. 

From June 3 to June 13 . 5 1 ' From June 14 to June 21 . 26 9 
From June 22 to Aug. 

27 . . . . 186 4 

From Au<r. 31 to Dec 27 96 2 



287 7 
or, 7 deaths and 280 recoveries. 



From Aug. 28 to Aug. 30 . 24 9 
Dec. 20 (cold aiFusion) . 1 

50 19 

or, 19 deaths and 31 recoveries. 



Thus, then, in the two irruptions, we get a result of eight 
deaths under the saline treatment, and 438 recoveries, or a mor- 
tality of less than three per cent, in a total number of 446 cases 
of Cholera, 201 of which had been cases of collapse. 

We may further mention, that in the year 1833 the Cholera agaia 
broke out in the prison, and that from July 29th to September 
19th there had been in all twenty-four cases, and only two deaths. 
This result in 1833, of so few cases, was, we beheve, partly 
attributable to the improved drainage. 

From the above facts, we feel ourselves entitled to draw the 
following conclusions : 

1st. The mortality from Asiatic Cholera, dm*ing the first out- 
break at Coldbath -fields Prison was reduced, under Dr. Stevens* 
and Mr. Wakefield's care, to three per cent, of those attacked. 
Strictly speaking, we might affirm, to less than one per cent., 
one only having died out of 159 patients that were treated on 
his plan ; for two deaths are to be attributed to imprudent ex- 
posure after convalescence had set in. 

2nd. The mortality, during the second outbreak, chiefly under 
Mr. Wakefield's and Dr. Stevens' care, under the saline treat- 
ment, was reduced to less than 3 per cent, of those attacked. 



THE SALINE TREATMENT. 165 

3rd. The statements of Sir David Barry and others, tending to 
demonstrate the non-existence of Cholera in the prison in the end 
of Jmie, have been clearly and completely refuted by the authen- 
ticated documents which have been submitted to us. We, there- 
fore, feel bound to declare, without hesitation, that the character 
of Dr. Stevens has been foully calumniated; and we call on those 
concerned either to confirm or to refute our assertion. 



From the immense success which attended the use of the saline 
remedies at Coldbath-fields Prison, it might naturally be expected 
that Dr. Stevens' method would have been universally adopted in 
public and private practice. But the suspicion cast on the truth of 
his statements, mdely circulated by a then-influential journal, 
and countenanced by the public authorities, prevented the ma- 
jority of medical men from having recourse to the new treatment. 
Some few, however, less influenced by prejudice, did give the 
method a fair trial. With the results of the experience of 
some of these, we shall close the present chapter. For obvious 
reasons, single cases, or those comprehending a short series, 
have been omitted ; though, if added together, they would form 
an imposing sum. 

A practitioner in Warrington (Dr. Kendrick) furnished the 
Medical Gazette^ with a table of 108 cases, the result of which 
shows that seventy-eight patients were treated in various ways, 
and all died. Seven were treated by the salines and bleeding : all 
recovered. Twenty-three were treated with the salines alone; 
twenty-one recovered, two died. The cases, apparently, were of 
the most severe kind. 

The report from the "Woolwich convict ship"t gives a tabular 
view of 148 cases treated by Mr. Bossey, with a result of 
36 deaths, and 112 recoveries. Out of this number, however, 
56 had been treated by bleeding and salines, with 45 recoveries : 
65 had been put under the salines alone, and out of these there 
were 56 recoveries; so that out of the 112 who were saved, no less 
than 101 were attributable to the saline treatment, in a gross 
number of 148 cases, 1 7 of which were treated on the plan of the 

* " Medical Gazette," vol. X., p. '31. t Ibid, vol. X., p. 729, 



166 THE SALINE TREATMENT. 

Board of Health, and 10 had been hospital patients already 
suffering from various diseases. Can exaggeration and mis-state- 
ment be applied to the returns of ]\Ir. Bossey ? 

We might here give a full detail of the saline treatment at the 
Greville-street Hospital. Suffice it to say, that after some difficulty 
with Dr. IMarsden, who at first pronounced the saline treatment to 
be " all quackery,^' his consent was obtained to a trial of it being 
made in that establishment ; and though even here some circum- 
stances have since transpired which would have disgraced the parties 
who made their attack on the treatment pursued at Coldbath-fields 
Prison, yet the result was, that at the end of the epidemic of 1832, 
Dr. Marsden published a paper, in which he stated, that of 81 
collapsed patients, treated by salines alone, only seven died.* Hence 
the mortality, even in collapsed cases, was reduced to 8'6 per cent. 
No amount of future prevarication can overthrow the value of this 
statement, which bears Dr. Marsden's signature. It is enough for 
us that Dr. Marsden says, in another paper, addi'cssed to the London 
Medical Journal, speaking of the " second stage " of Cholera : — 
" The following plan must be rigidly observed, it being the only 
one yet known that has restored a single patient, — it is the saline 
treatment suggested hy Dr. Stevens." 

Again, w^e might refer to Abchurch-lane ; but to do so effectually 
we should be compelled to go into more detail than would be 
consistent with this sketch. Suffice it to say, that at Abchm*ch- 
lane Hospital, at Bridewell, at St. Luke's Hospital, and at St. 
Giles's, the saline treatment was employed ; and so far as it 
was permitted to have fair play, the results were, generally, quite 
equal to those already stated. With respect to St. Luke's Hos- 
pital, we have the testimony both of Dr. Cambridge and of Mr. 
Ranee ; the former of whom says : " from my own personal observa- 
tion and experience in the treatment of this direful disease, I 
am decidedly of opinion that the saline remedies are not only the 
most rational, but decidedly the most successful that have yet been 
tried ; " and the latter testifies as follows : — " From what I have 
witnessed, it is but justice to Dr. Stevens to acknowledge, that I 
place more reliance upon the saline treatment than on any other 
that has yet been recommended." t 

Again, in 1833, Dr. Andrew Ure, writing to Dr. Stevens (who 

* " Medical Gazette," vol. XI., p. 17. t It)id, vol. XI., \\ 83. 



THE SALINE TREATMENT. 167 

was then in Denmark), says : " A few weeks ago, I met young 
Dr. Pinckard, Physician to St. Giles's Hospital, who had originally 
slighted your saline practice in Cholera. He told me, further 
experience had eventually convinced him of its efficacy, and he 
had hetter cases to adduce in its favour than any which you 
yourself had been able to bring forward ; " and Dr. lire adds : 
" In case, therefore, of a return of this epidemic, you will be 
the sole practitioner, at least by proxy." 

The last testimony we shall quote is that of Mr. Moss, of 
Windsor, who says, in a letter to the Medical Gazette,^ " Such 
is my faith in the efficacy of this (the saline) treatment, that I 
would undertake to cure, with the carbonates alone, almost every 
case that occurred, if seen in the first stage of the disease ; but 
in the last stage I should certainly adhere strictly to Dr. Stevens' 
plan. My belief is, these salts possess a specific influence in 
neutralizing or destroying the poison of Cholera, when diffused 
in the human system; and I am far from solitary in deeming 
the discovery of this remedy as one of the most important and 
beneficial of the age, and its author, not only a real bene- 
factor to mankind in general, but one of the greatest contri- 
butoi"s to medical science." 

INIany other testimonies of a similar kind might be collected at 
home and abroad — from foes as well as from friends ; but to record 
their results, or discuss their bearing, would carry us far beyond 
the limits assigned to the present work. Wherever the saline 
treatment has been fairly and fully tried — upon the principles and 
according to the plan of Dr. Stevens — ^we find evidence that the 
mortality of Cholera has been reduced below that of typhus fever. 
Such evidence we obtain not only from the discoverer and his 
more immediate friends, but from practitioners in various parts of 
the world — from men totally unacquainted with Dr. Stevens — 
from men above suspicion, and to whom no unworthy motives can 
be attributed. To their testimony we join our own — the result of a 
conscientious examination of the whole subject ; and unmixed will 
be our satisfaction if we shall find that our humble efforts have 
served to elicit the truth. 

We have now, as we believe, given a succinct and true 
history of the saline treatment in 1832 — 33. It may be asked, 

* ■' Medical Gazette," vol. X., p. 711. 



168 THE SALINE TREATMENT. 

What has this to do with au historical sketch of the Cholera for 
1849 ? Our answer is — that it is most intimately connected with 
it. Those who refer to the many modes of treatment that have 
been proposed, with very slight evidence of their efficacy, will, we 
think, be led to study with deep interest the details now supplied, 
as to a pai'ticular plan of treatment adopted in 1832, under which 
we show, that, out of at least 1,000 cases, the mortality was about 
5 per cent. Why, then, with this result, was the last out- 
break so fearfully destructive to human life ? Had the proper- 
ties of the neutral salts changed? Was the Cholera of 1832 a 
different disease from that of 1849 ? or, if it were the same 
disease, were the constitutions of prisoners more susceptible of a 
particular remedy than those untainted with crime ? Did the 
atmosphere of a prison favour the exhibition of the remedy — while 
that of the private dwelling effectually impeded it ? Assuredly 
not. The answer will be found in the simple fact, that a man 
of unimpeachable honour and integrity, — one who had already 
done much for medical science, — having discovered and success- 
fully employed a remedy for this disease, was assailed and vilified 
in the most unjust manner ; and a practice calculated to mitigate 
the sufferings of mankind, and to check the progress of mortality, 
repudiated and condemned, for purposes to which true science 
and the public good were total strangers. 

The success which has attended the saline treatment is no 
longer a matter of speculation ; — " demonstratum est quod erat 
demonstrandum.'' The facts speak for themselves ; and accordingly, 
however ill-treated and calumniated Dr. Stevens may have been, 
he can now afford to look back with satisfaction upon his past 
career; and, remembering that the advocates of truth have too 
often to contend with the machinations of self-interest, preju- 
dice, and ignorance, he may reasonably congratulate himself 
upon the triumph that time has achieved. The result, too, beai*s 
its own moral : — the young aspirant to professional honours may 
hereby be forewarned of the jealousies and hostilities against 
which he may have to contend; and he may moreover discover 
beacons, which would warn him from the shoals and sunken 
rocks upon which his fair fame may otherwise be wi-ecked. 

To the government of this country — to those in whose hands is 
placed the safeguard of their fellow-men, we would make a last 



THE SALINE TRExVTMENT. 169 

and confident appeal. The question here debated is one of no 
minor import. It affects the lives of thousands_, and the happi- 
ness of the whole community. The plague, which has passed 
away, may return to-morrow; and with it again will come desola- 
tion and deatli. The means of treatment hitherto employed have, 
with one great exception, confessedly proved inefficient. Must we, 
then, abandon the field in despair ; and can it be said with truth 
that medical science has left us without one ray of hope ? The 
facts recorded in the preceding pages demonstrate the contrary. 
A successful mode of combating Asiatic Cholera has been dis- 
covered. However much envy and malice may have obscured the 
truth, still the science of medicine has not proved false to her 
followers. A fact of the most vital importance has by misrepre- 
sentation been confounded with falsehood, and many thousand 
lives, in consequence, been blindly sacrificed ; and to test the 
value of this assertion — to disengage truth from the chaos of 
calumnies into which it has been plunged — to arrest the hand of 
death, and disseminate life-giving knowledge, are acts worthy of 
an enlightened and beneficent government. 

After the statements which have here been made, it becomes 
a duty, from which no government can honourably shrink, to 
make the necessary investigation. In matters affecting human 
life, there is no statute of limitation ; and now — at the eleventh 
hour — we earnestly, and confidently call on Her Majesty's 
Government to inquire, ere too late, into a matter from the 
neglect of which incalculable injury must inevitably ensue. 



INDEX 



A 

PAGE 

Abandon- MEKT of the saline treatment, 

and consequent mortality 157 — ICO 

Abchurch-lane Hospital 166 

Acid, a peculiar, pervading the air — an 

alleged cause of Cliolera, and proposed 

remedial measure 20 

Actuarius 17 

Advance of the disease 77 

" Aide toi, le ciel t'aidera " 50, 51 

Albion-terrace S6, 87 

Andrance, M 20 

Appearance of Cholera in England 52 

Approach of Cholera to England 13 

Arabian physicians 17 

Aretaeus 17 

Artizans, ratio of mortality among 105 

Atmospheric phenomena of August, 

1S49 89, 90, 91 

August, 1849, atmospheric phenomena 

of 89, 90, 91 

B 

Barometer, indications of, during the 

season of Cholera 106, 107 

Barry, Sir David 156—164 

"Belgravia" 43 

Bengal 4 

Bermondsey 86 

Bethnal-green 41 

Bill providing for the interment of the 

Dead 129 

Bills of mortality, old, Heberden on 110 



PAGE 

Bird, Dr. James 24 

Birmingham, its immunity from Cholera 7, Gl 

Blacklock, Mr. Ambrose 20, 23 

Board of Health provided and constituted 72 

Board of Health, 1832 155—16.'; 

Bossey, Mr., Report of, on the Saline 

Treatment 165 

Bowie, R., Esq., evidence of, before the 

Sanitary Commission 53, 124 

Bridewell Hospital „ 166 

Brittan, Dr 33, 34, 35 

Brunei, Mr., Report of, on the Sewerage 

of the City 72, 73 

Buchanan, Dr. Andrew 25 

Budd, Dr 33,34,35 

Bunhill-fields 114 

Burial-grounds, condition of 113 

St. Ann's, Blackfriars 115 

Lock burial-ground, Dover-road, South- 

wark 115 

St. George-the-Martyr, Southwark 115 

Parker-row, Dockhead 115 

Tottenham Court-road chapel 116 

New Bunhill-fields 116 

St. George's, Hanover square (Uxbridge- 

road) 116 

St. Mary's, Newington, Surrey IIG 

New Bunhill-fields Cemetery 116 

St. Olave's and St. John's, Tooley-street 117 
St. George's Lutheran church. White- 
chapel 117 

St. Botolph's, Aldgate 117 

St. Olave's, Silver-street, Falcon-square 117 
Tavistock burial-ground, Drury-lane .... 11& 



INDEX. 



PAGE 

Burial-grounds, condition of, (continued) — 

Spa-fields 118 

St. Giles'-in-the-fields 118 

St. Giles' cemetery, Old Pancras-road ... 118 
Christchurch, Broadway, Westminster.. 119 

St. Clement Danes, Portugal-street 120 

St. Bartholomew the Great, (1, 2, and 3,) 

121, 122 

Wade-street, All Saints, Poplar 122 

St. James' chapel, Hampstead-road 123 

New Bunliill-fields Cemetery 123 

Butler's-place, Horsleydown 123 

St. Stephen's, Walbrook 124 

Barking churchyard, Great Tower-street, 

City 124 

Pauper, of St. Bride's, Fleet-street 125 

St. Andrew's, Holborn 126 

Trinity, Fetter-lane 126 

Wycliffe, Commercial-road, East 126 

Burial vaults 127 

C 

Cassics Medicus 17 

Cases of Cholera in 1832 155—165 

Celsus 16, 18 

Cessation of Cholera 92 

Chambers, Dr 20 

Chamber's Edinburgh Journal, " General 

Considerations on Epidemic Diseases," 27, 28 
Chart of the River Thames and the several 

Districts of London, with their water 

supply 96, 97 

Chesterton, Colonel 158—162 

Clergymen, ratio of mortality among 104 

Ccelius Aurelianus 17 

Coldbath-flelds Prison (1832) 154—165 

College of Physicians, report of, on the 

views of Drs. Brittan, Swayne, and 

Budd 34 

Commission of Inquiry into the Sanitary 

Condition of London, appointed 52 

Common Council, meeting of 78 

Conclusion arrived at on the evidence of 

the saline treatment 168, 169 

Cordons Sanitaire 14 

Do. Order in Council on 14 

Corpses, disposal of, in the dwellings of 

the poor 128, 129 

Crawford, Dr. Adair 22 

Crooke, Mr 158 

D 

Debate in Parliament, a 69 

Debate in Court of Common Council, a ... 79 

Decline, gradual, of Cholera 92 

Derivation of the term " Cholera" 16 

Diodes 17 



PAGE 

Discoveries of Dr. Stevens 151 

Doorjak, M. Th 25 

Doubleday, Edward, Esq., evidence of 

before the Sanitary Commission 59 

Dunglison 20 

Dwellings of the poor, a source of 

Cholera 37—51 

£ 

Ebrikgton, Lord, on the dwellings of the 

poor „ 4) 

Electrical changes 36 

Electricity 28 

England, appearance of Cholera in 52 

Ergotism 29 

Evans, Dr., U.S 26 

Evidence before the Sanitary Commis- 
sion 53 — 67 

Extramural sepulture, general scheme of, 
reported on 129 



Fable of La Fontaine, rendered by the 

Medical Times 50, 51 

First case of Cholera 74 

First irruption of Cholera in Coldbath- 

fields prison 155 

First outbreak, the 7t 

Fungi, the theory of, in Cholera dis- 
charges 33, 34, 35 

G 

Gavin, Dr. Hector, on the dwellings of 

the poor 41, 49, 50, 51 

Gazette, the, notification in 80 

General Board of Health provided and 

constituted 72 

General thanksgiving 92, 93 

Gentlemen, ratio of mortality among 104 

Glaislier, Mr., observations of 84, 89 

Government, official communications to, 

8, 9, 10, 11 

Grainger, Mr 123 

Greville-street Hospital 166 

Guy, Dr. W. A., table of proportionate 
mortality among various trades and 
conditions 103, 104, 105, 106 

H 

Hampstead 87 

Heberden on the old bills of mortality 110 

Hertslet, Mr., evidence of before the Sani- 
tary Commission ,.. 61 

Hill Cholic, curious Indian superstition 
respecting 22 



INDEX. 



PAGE 

Hippocrates S — 16 

" Homes" of the Poor 42—41 

Hooper, R. L., Esq., evidence of before 

the Sanitary Commission 55 

Horsleydown 31 

House of Commons, debate in, on Public 

Health Bill 69 

House of Lords, debate in, on Public 

Health BUI 71 

Hygienic rules neglected in erecting 

d-\vellings for the poor 42 

I 

India 4 

Influence of quality of water supply 100 

Influence of quality of water supply, the 

Registrar-general, on 101 

Influence on human life of intramural 

interment 112, 113 

Instructions to the public by the Russian 

authorities 11, 12, 13 

Interment, bill to provide for 129 

Intramural interment 112, 129 

J 
Jenser, Dr 35 

K 

Keih, Dr. James, Knt 20, 22 

Kendrick, Dr., Report of, on the Saline 

Treatment 1C5 

Knox, Dr. Alexander, on the various ex- 
citing causes of Cholera 21 

La Foxtaike, fable of 50, 51 

Labourers, ratio of mortality among 105 

Labouchere, Mr., bill brought in by, to 

prevent contagious disorders among 

sheep and cattle 69 

Leadham, T. R., Esq., evidence of before 

the Sanitary Commission 57 

Lewis, Dr. Waller 127 

Locality of Cholera identical with that of 

typhus 42 

Lord Mayor, the 81 

M 

Magistrates, S:c., ratio of mortality 
among 104 

Marsden, Dr 166 

M'Cann, N., Esq., Evidence of before the 
Sanitary Commission 61 

McGregor, Dr. W. L 25 



page 

" Medical Galvanism" 20 

Medical officer, debate on the appoint- 
ment of a, in the Common Council 79 

Medical Times, on the dwellings of the 

poor 48, 49, 50, 51 

Meteorology, daily, during the outbreak 

of Cholera end 

Microscopic bodies in Cholera, dis- 
charges 33,34,35 

Millbank Penitentiary 78 

Milroy, Dr 115 

Morpeth, Lord, Bill brought in by, for Re- 
moval of Nuisances, and Prevention of 

Contagious Diseases 69 

Moral and physical disease 101, 102 

Mort de chien 4 

Mortality from Cholera, estimated on sex 

and conditions of life 102, 103 

Mortality, the highest, in Cholera 01 

Moss, Mr., Report of, on the Saline Treat- 
ment 167 

N 

Nature and causes of Cholera. ...19, 29, 30, 36 
Newspaper writers, various opinions of 

28, 29 
Nonnus 17 

O 

Official communications to Govern- 
ment 8, 9, 10, II 

On African typhus and yellow fever 154 

" Opaque Smoke " 69 

Opinions, ancient, on the origin, nature, 

and causes of Cholera 3, 16, 17, 18 

Opinions of various bodies on the influ- 
ence of intramural interment 112, 113 

Opinions, modern, on the origin, nature, 

and causes of Cholera 30—36 

Order in Council 76 

Order of Police Commissioners 81 

Oribasius 17 

Orton, Mr 20 

O'Shaughnessy, Dr 157, 158 

Ousby, Mr 161 

Ozone 29, 35, 36 

P 

Parkes, Dr 77 

Parliament 129 

Paulus CEgineta 16 

Pellarin, M 33 

Per centage of deaths under the saline 

treatment 162 — 168 

Per centage of deaths under various pro- 
posed remedies 150 



INDEX. 



PAGE 

Physical and moral disease 101, 102 

Physicians, surgeons, and general prac- 
titioners, ratio of mortality among 104 

Picture of " the happy homes of Eng- 
land" 45, 46, 47,48 

Pinckard, Dr 167 

Plague, the, of 1566 106, 107 

Plagues, the, of 1603, 1625, 1636, and 
1665, compared with the Cholera as to 

season 108, 109 

Plan of Dr. Stevens' treatment 152 — 154 

Plans for improving sewerage 76 

Police Commissioners, order of 81 

Poor, the dwellings of 37—51 

Population, comparative view of the, as 

respects Cholera 107 

President of the College of Physicians, 

letter of, to the Lord Mayor 82 

Preventive measures 97 

Professions, learned, ratio of mortality 

among 104 

Progress, foreign, of Cholera 4—14 

Progress, geographical, of Cholera the 

reverse of the earth's rotation 4 

Proposed cures for Cholera 130 — 149 

Public Health Bill 60 

Q 

Quarantine 14 

Gueen, the speech of, on proroguing Par- 
liament 75 

R 

Registrar-General, statements of, 87, 88, 
91, 92, 100, 101 

Remedies, proposed 130 — 149 

Report of the Sanitary Commission 68 

Results of old treatment 156 — 165 

Results of saline treatment 156 — 165 

Retention of the dead in small dwellings, 

moral and physical influence of 128, 129 

Rotch, Mr 161 

S 

Saline treatment of Cholera 150 — 169 

Saline treatment proved successful ...156 — 167 
Sanitary condition of London in 1832 and 

1847 compared 52—68 

Schbnhein 35 

Season, its influence on the mortality of 

Cholera 106 

St. Giles's Hospital 160 

St. Luke's Hospital... 166 

Second outbreak, the 85 

Sepulture, intramural 112 — 129 

, extramural 122 



PAGE 

Sewerage of London, inquiry into 52 — 67 

Sheffield, sanitary condition of 45 

Simpson, W., Esq., evidence of, before 

the Sanitary Commission 58 

Smith, Mr. B., tables of 106, 108, 110 

Snow, Dr 31—33 

Statistics : 

District 82, 93 

Age 83 

Duration of attack 83 

Sex 83, 108 

Atmospheric Phenomena 84 

of August, 1849 ...89—91 

Progressive advance of the disease 86 

Positions of districts with respect to 

the river, and sources of water supply 96 
Elevation of dwellings above high-water 

mark 98, 99 

Average annual value of houses 98, 99 

Average cost of house-room 98, 99 

Annual mortality from all causes from 

1838 to 1844 98, 99 

Districts supplied by Nine Water Com- 
panies 98, 99 

Density of population 98, 99 

Deaths from Cholera to 10,000 persons 

living ....98, 99 

Sources of water supply 98, 99 

Influence exercised by the quality of 
water over the mortality from Cholera 100 

Moral and physical disease 101, 102 

Mortality from Cholera estimated on 

sex and conditions of life 102, 103 

Mortality from Cholera, proportion of, 
among various trades and condi- 
tions 103—106 

Chart of the progress of Cholera, the 
Plague of 1665, and of all other dis- 
eases, with the temperature and baro- 
metrical indications during the same 

period 106—107 

Comparative view of the population, 
(male and female, and at various 

ages), as respects Cholera 107 

The four plagues of 1603, 1625, 1636, and 
1665, compared with the Cholera, as 

to season 108, 109 

Comparative view of typhus fever, and 
other diseases, with the Cholera, 

during the same season Ill, 112 

Intramural interment 113, 114 

Bunhill-lields 114 

Various proposed remedies ; names of 
the proposers ; nature of the remedy ; 
authority, and date of proposal ...130—145 

Saline treatment 155 — 167 

The daily meteorology during the second 
outbreak of Cholera end 



INDEX. 



PAGE 

Stevens, Dr. — 

Discoveries of. 151 

Plan of treatment 152—154 

Coldbath-fields Prison (1832) 154—165 

On African typhus and yellow fever 154 

First irruption of Cliolera in Coldbatli- 

fields Prison 155 

Wakefield, Mr 155—165 

Barry, Sir David 156—164 

O'Shaughnessy, Dr 157, 158 

Crooke, Mr 158 

Chesterton, Colonel 158—162 

Rotch, Mr 161 

Ousby, Mr 161 

Cases of Cholera in 1832 155—165 

Results of old treatment 156—165 

Results of saline treatment 156—165 

Board of Health, 1832 155—165 

Abandonment of the salines, and con- 
sequent mortality 157, 160 

Saline treatment proved successful 156 — 16.7 
Warrington, the salines successfully 

used at 165 

Kendrick, Dr., Report of 165 

Woohvich convict ship 165 

Bossey, Mr., Report of 165 

Greville-street Hospital 166 

Marsden, Dr 166 

Abchurch-lane Hospital 166 

St. Giles's Hospital 166 

Bridewell Hospital 166 

St. Luke's Hospital 1' 6 

Ure, Dr. Andrew 166 

Pinckard, Dr 167 

Windsor 167 

Moss, Mr., Report of 167 

Testimonies to the value of the saline 

treatment 165—167 

Conclusion arrived at on the evi- 
dence 168, 169 

Sulphur, a deficiency of, in diet, an alleged 

cause of Cholera 23 

Sutherland, Dr 114 

SwajTie, Dr 33, 35 



PAGE 

T 

Tavler, Esq., evidence of before the Sani- 
tary Commission 60 

Testimonies to the value of the saline 

treatment 165 — 167 

Thames, its southern banks 96 

Thames, diagram of 96, 97 

Thanksgiving, General 92, 93 

Thermometer, its condition during the 

season of Cholera 106, 107 

Tradesmen (masters), &c., rate of mor- 
tality among 104 

Typhus fever, and all diseases, compared 
with Cholera, during the same season 

111, 112 



Ure, Dr. Andrew. 



V 
Vaults, burial 127 



W 

Wagstaffe, F., Esq., evidence of, before 

the Sanitary Commission 56 

Wakefield, Mr 155-165 

Walker, Mr., report of, on the sewage of 

the City 72, 73 

Warrington, the salines successfully used 

in 165 

Water, vitiated, as a cause of Cholera ...31 — 33 

Watson, Dr. Seth B 20 

Webb, Professor 22 

Webster, Dr. John 26 

Wilkinson, Mr., "Elements of Medical 

Galvanism" 20 

Wilson, Dr. John 20, 23 

Windsor 167 

Woolwich 77 

Woolwich, convict ship 165 



ERRATA. 



Page 16. — 13th line from bottom, for " vilis " read " bills." 
Page 108.— 3rd line from bottom, after 1625, insert 1636. 
Page 123.— 14th line, for " Mr. Ranger" read " Mr. Grainger." 



DR. BUSHNAN'S WORKS. 



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